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General NPI Number Information
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NPI Number | 1659443299
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Entity Type | Individual
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Provider Name | MARY LYNNE REUSS M.D.
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Gender | Female
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Dates
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Enumeration Date | 11/15/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 4600 MONTGOMERY BLVD NE # A SUITE 101
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-1210
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Country | US
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Telephone | 505-884-9687
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Fax | 505-884-9688
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Provider Business Mailing Address
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Address Line | PO BOX 2160
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City | CORRALES
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State | NM
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Zip | 87048-2160
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Country | US
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Telephone | 505-884-9687
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Fax | 505-884-9688
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 2003 0502
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | G33665
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 122409-1
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 207VM0101X
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Taxonomy Name | Maternal & Fetal Medicine Physician
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License Number | 2003-0502
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License Number State | NM
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