MEDICARE: TODD DETTMER

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	2084A2900X	Neurocritical Care Physician	W1154	TX
2	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	W1154	TX
3	207P00000X	Emergency Medicine Physician	AB7003469-B439	NM
4	207P00000X	Emergency Medicine Physician	MD 60152927	WA
5	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	MD2010-0476	NM
6	207LC0200X	Critical Care Medicine (Anesthesiology) Physician	MD2010-0476	NM
7	207LC0200X	Critical Care Medicine (Anesthesiology) Physician	AB7003469-B439	NM

General Provider Information

NPI Number	:	1750589727
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TODD DETTMER

Provider Business Mailing Address
First Line	:	5605 N MACARTHUR BLVD STE 740
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75038-2626
Country	:	US
Telephone Number	:	214-960-5681
Fax Number	:	214-960-5681

Provider Business Practice Location Address
First Line	:	UNM DEPT OF EMERGENCY MEDICINE MSC11 6025
Second Line	:	1 UNIVERSITY OF NEW MEXICO
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87131-0001
Country	:	US
Telephone Number	:	505-272-5062
Fax Number	:	505-272-6503

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

Provider Enumeration Date	:	07/10/2007
Last Update Date	:	03/12/2026

Similar Medicare Providers

1215525902 — AUGUST VOJDANI PA-C
Practice Location Address:

4588 PARADISE BLVD NW , MEDICARE ADVANTAGE CLINIC
ALBUQUERQUE, NM
87114-4105

Practice Phone: 505-998-1840
Practice Fax: 505-998-1841

1356358311 — JONATHAN L. MARINARO MD
Practice Location Address:

ANESTHESIOLOGY & CRITICAL CARE MEDICINE , UNMH - 2211 LOMAS BLVD. NE
ALBUQUERQUE, NM
87131-0001

Practice Phone: 505-272-2610
Practice Fax:

1144545773 — TOBIAS BENJAMIN KULIK MD
Practice Location Address:

4401 WORNALL RD
KANSAS CITY, MO
64111-3241

Practice Phone: 816-932-2261
Practice Fax:

1376287847 — NATALEE NAOMI PRICE
Practice Location Address:

UNIVERSITY OF NEW MEXICO , DEPT. OF PSYCHIATRY & BEHAVIORAL SCIENCES, MSC09-5030
ALBUQUERQUE, NM
87131-0001

Practice Phone: 505-272-5428
Practice Fax:

1740676634 — CHRISTOPHER STEPHEN BOSSART M.D.
Practice Location Address:

1 UNIVERSITY OF NEW MEXICO , MSC 11-6025
ALBUQUERQUE, NM
87131-0001

Practice Phone: 505-272-5062
Practice Fax:

1750278768 — CATHERINE MARIE LEMONTANGUE
Practice Location Address:

1 UNIVERSITY OF NEW MEXICO # 95040
ALBUQUERQUE, NM
87131-0001

Practice Phone: 505-272-9864
Practice Fax:

Directions to “ TODD DETTMER ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.