MEDICARE: ANA G HUAMAN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	90-213	NM

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00163555	OTHER	NM	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	NM009M96	OTHER	NM	BLUE CROSS BLUE SHIELD
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	201055717	OTHER	NM	PRESBYTERIAN HEALTH PLAN
5	PROVP13283	OTHER	NM	MOLINA HEALTH CARE

General Provider Information

NPI Number	:	1043370554
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANA G HUAMAN M.D.

Provider Business Mailing Address
First Line	:	8100 WYOMING BLVD NE STE M4
Second Line	:	PMB 293
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87113-1963
Country	:	US
Telephone Number	:	505-266-8200
Fax Number	:	505-256-7565

Provider Business Practice Location Address
First Line	:	3901 GEORGIA ST NE STE G-2
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87110-1359
Country	:	US
Telephone Number	:	505-266-8200
Fax Number	:	505-256-7565

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/12/2006
Last Update Date	:	02/26/2019

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Directions to “ ANA G HUAMAN M.D.” Practice Location

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