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General NPI Number Information
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NPI Number | 1639125073
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Entity Type | Individual
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Provider Name | FRED GINSBURG MD
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Gender | Male
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Dates
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Enumeration Date | 05/26/2006
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Last Update Date | 12/17/2021
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Provider Practice Location Address
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Address Line | 5901 ROYAL OAK DR NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87111-6244
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Country | US
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Telephone | 505-503-8864
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Fax |
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Provider Business Mailing Address
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Address Line | 5901 ROYAL OAK DR NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87111-6244
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Country | US
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Telephone | 419-885-8253
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Fax |
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | MD2012-0016
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License Number State | NM
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