Healthcare Provider Details

I. General information

NPI: 1760757199
Provider Name (Legal Business Name): DREW K NEWHOFF M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2012
Last Update Date: 10/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4304 CARLISLE BLVD NE
ALBUQUERQUE NM
87107-4811
US

IV. Provider business mailing address

201 CEDAR ST SE STE 6600
ALBUQUERQUE NM
87106-5411
US

V. Phone/Fax

Practice location:
  • Phone: 505-888-1075
  • Fax: 505-888-1082
Mailing address:
  • Phone: 505-888-1075
  • Fax: 505-888-1082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberMD2014-0715
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: