Healthcare Provider Details
I. General information
NPI: 1275870867
Provider Name (Legal Business Name): ALBUQUERQUE NEW MEXICO PHYSICIANS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/16/2013
Last Update Date: 04/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
117 E 19TH ST
ROSWELL NM
88201-5151
US
IV. Provider business mailing address
300 S PARK RD SUITE 400
HOLLYWOOD FL
33021-8593
US
V. Phone/Fax
- Phone: 877-693-5700
- Fax:
- Phone: 800-815-8377
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DAVID
S.
SCHILLINGER
Title or Position: PRESIDENT
Credential: MD
Phone: 877-693-5700