Healthcare Provider Details

I. General information

NPI: 1699279562
Provider Name (Legal Business Name): ELSPETH ELAINE SPRINGSTED MBBS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2018
Last Update Date: 06/18/2025
Certification Date: 06/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

465 SAINT MICHAELS DR STE 117
SANTA FE NM
87505-7621
US

IV. Provider business mailing address

707 E PALACE AVE APT 31
SANTA FE NM
87501-6403
US

V. Phone/Fax

Practice location:
  • Phone: 505-984-2600
  • Fax:
Mailing address:
  • Phone: 505-795-1436
  • Fax:

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 TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD2022-0228
License Number StateNM
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0101272741
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberMD2022-0228
License Number StateNM
# 5
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberMD2022-0228
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: