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General NPI Number Information
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NPI Number | 1528551991
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Entity Type | Individual
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Provider Name | BRIAN NAIZER MD
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Gender | Male
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Dates
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Enumeration Date | 06/11/2018
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Last Update Date | 07/27/2021
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Provider Practice Location Address
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Address Line | 6701 JEFFERSON ST NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-4318
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Country | US
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Telephone | 505-727-6200
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Fax | 505-727-9590
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Provider Business Mailing Address
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Address Line | 6701 JEFFERSON ST NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-4318
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Country | US
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Telephone | 505-727-6200
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Fax | 505-727-9590
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | BP10065099
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD2021-0790
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License Number State | NM
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