Healthcare Provider Details

I. General information

NPI: 1306055751
Provider Name (Legal Business Name): ELISABETH MAGDALENE BARKEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 SAINT MICHAELS DR A 201
SANTA FE NM
87505-7672
US

IV. Provider business mailing address

435 SAINT MICHAELS DR A 201
SANTA FE NM
87505-7672
US

V. Phone/Fax

Practice location:
  • Phone: 505-982-9282
  • Fax: 505-988-1106
Mailing address:
  • Phone: 505-982-9282
  • Fax: 505-988-1106

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number896
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: