Dr Catherine Marie Radovich, MD | |
516 Nizhoni Blvd, Gallup Indian Medical Center, Gallup, NM 87301-4555 | |
(505) 722-1000 | |
Not Available |
Full Name | Dr Catherine Marie Radovich |
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Gender | Female |
Speciality | General Practice |
Location | 516 Nizhoni Blvd, Gallup, New Mexico |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1699743328 | NPI | - | NPPES |
414904 | Medicaid | AZ | |
S0796 | Medicaid | NM |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | 91287 (New Mexico) | Primary |
Entity Name | Dhhs,phs,naihs, Gallup Indian Medical Center |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1225002322 PECOS PAC ID: 3173436409 Enrollment ID: O20031111000840 |
Mailing Address | Practice Location Address |
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Dr Catherine Marie Radovich, MD Po Box 1337, Gallup Indian Medical Center, Gallup, NM 87305 Ph: (505) 722-1000 | Dr Catherine Marie Radovich, MD 516 Nizhoni Blvd, Gallup Indian Medical Center, Gallup, NM 87301-4555 Ph: (505) 722-1000 |
Dr. Cleora Shunkamolah, M.D. General Practice Medicare: Accepting Medicare Assignments Practice Location: 516 E Nizhoni Blvd, Gallup, NM 87301 Phone: 505-722-1000 | |
Dr. Paula Renee Mora, M.D. General Practice Medicare: Medicare Enrolled Practice Location: 516 E Nizhoni Blvd, Gallup, NM 87301 Phone: 505-722-1482 Fax: 505-722-1629 | |
Dr. Michael Eric Ivory, DO General Practice Medicare: Not Enrolled in Medicare Practice Location: 516 E. Nizhoni Blvd., Gallup, NM 87301 Phone: 505-722-1000 Fax: 505-726-8740 | |
Dr. Jeffrey Joseph Hawker, M.D. General Practice Medicare: Accepting Medicare Assignments Practice Location: 516 E Nizhoni Blvd, Gallup, NM 87301 Phone: 505-722-1000 Fax: 540-224-1933 |