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General NPI Number Information
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NPI Number | 1659525335
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Entity Type | Organization
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Legal Business Name | WOMEN'S PELVIC SPECIALTY CARE
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Dates
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Enumeration Date | 11/08/2008
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Last Update Date | 11/08/2008
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Provider Practice Location Address
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Address Line | 4705 MONTGOMERY BLVD NE SUITE 201
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-1226
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Country | US
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Telephone | 505-899-0443
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Fax | 505-888-1398
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Provider Business Mailing Address
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Address Line | 4705 MONTGOMERY BLVD NE SUITE 201
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-1226
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Country | US
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Telephone | 505-899-0443
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Fax | 505-888-1398
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Authorized Official
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Title or Position | PRESIDENT, SECRETARY
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Name | DR. DOROTHY NAOMI KAMMERER-DOAK
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Credential | MD
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Telephone | 505-888-0443
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 93-295
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License Number State | NM
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