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General NPI Number Information
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NPI Number | 1801355508
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Entity Type | Individual
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Provider Name | ALEXANDRA MICHAELA DRYMON D.O.
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Gender | Female
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Dates
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Enumeration Date | 03/13/2019
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Last Update Date | 01/30/2025
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Provider Practice Location Address
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Address Line | 121 EL PASO RD GENERAL SURGERY - RUIDOSO
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City | RUIDOSO
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State | NM
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Zip | 88345-6033
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Country | US
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Telephone | 575-630-8350
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Fax | 575-257-4055
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Provider Business Mailing Address
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Address Line | PO BOX 26666 PHS PROVIDER ENROLLMENT
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City | ALBUQUERQUE
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State | NM
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Zip | 87125-6666
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Country | US
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Telephone |
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | DO2024-0072
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License Number State | NM
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