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General NPI Number Information
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NPI Number | 1700806452
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Entity Type | Individual
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Provider Name | IMRAN K ALAM MD
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Gender | Male
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 04/25/2008
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Provider Practice Location Address
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Address Line | DEPARTMENT OF NEUROSURGERY MSC 10 5615
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City | ALBUQUERQUE
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State | NM
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Zip | 87131-0001
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Country | US
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Telephone | 505-220-8102
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4032
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City | ALBUQUERQUE
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State | NM
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Zip | 87196-4032
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Country | US
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Telephone | 505-220-8102
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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 | 2084N0600X
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Taxonomy Name | Clinical Neurophysiology Physician
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License Number | TT2007-0711
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | TT2007-0711
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License Number State | NM
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Taxonomy #3
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Taxonomy Code | 246Z00000X
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Taxonomy Name | Other Specialist/Technologist
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License Number | DABNM45
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 246ZS0410X
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Taxonomy Name | Surgical Technologist
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License Number | DABNM45
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License Number State | NY
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