MEDICARE: JAMI DALENE FROST MD

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	2080P0207X	Pediatric Hematology & Oncology Physician	96-248	NM

General Provider Information

NPI Number	:	1235146275
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMI DALENE FROST MD

Provider Business Mailing Address
First Line	:	4101 INDIAN SCHOOL RD NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87110-3988
Country	:	US
Telephone Number	:	505-727-5697
Fax Number	:

Provider Business Practice Location Address
First Line	:	4101 INDIAN SCHOOL RD NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87110-3988
Country	:	US
Telephone Number	:	505-727-5697
Fax Number	:

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

Provider Enumeration Date	:	08/02/2006
Last Update Date	:	05/17/2011

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