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NPI Code Detail

MEDICARE: GERHARD Y NYASE M..D.

MEDICARE: GERHARD Y NYASE 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
1207Q00000XFamily Medicine PhysicianMD2007-0117NM

General Provider Information

NPI Number : 1114940822
Entity Type Code : Individual
Provider Name (Legal Business Name) : GERHARD Y NYASE M..D.
Provider Business Mailing Address
First Line : PO BOX 26028
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87125-6028
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9101 MONTGOMERY BLVD NE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87111-2405
Country : US
Telephone Number : 505-275-4288
Fax Number : 505-275-4203
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/25/2006
Last Update Date : 12/10/2024

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Directions to “ GERHARD Y NYASE M..D.” Practice Location

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