Mary Poel, MD | |
2111 College Dr, Gallup, NM 87301-5600 | |
(505) 863-1820 | |
Not Available |
Full Name | Mary Poel |
---|---|
Gender | Female |
Speciality | Pediatrics |
Location | 2111 College Dr, 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 |
---|---|---|---|
1356313647 | NPI | - | NPPES |
NM002153 | Other | NM | BCBS |
PROVP15475 | Other | NM | MOLINA |
10002116 | Other | NM | LOVELACE HEALTH/SALUD |
7849 | Medicaid | NM | |
85031326887301A165 | Other | NM | CHAMPUS |
228719 | Medicaid | AZ |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 81-290 (New Mexico) | Primary |
Entity Name | Rehoboth Mckinley Christian Health Care Services, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1720084999 PECOS PAC ID: 1759293855 Enrollment ID: O20031105000466 |
Mailing Address | Practice Location Address |
---|---|
Mary Poel, MD 1901 Redrock Dr, Pfs Dept, Gallup, NM 87301-5683 Ph: (505) 863-7000 | Mary Poel, MD 2111 College Dr, Gallup, NM 87301-5600 Ph: (505) 863-1820 |
Dr. Carlos Manuel De Sanctis, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 516 E. Nizhoni Blvd., Gallup, NM 87301 Phone: 505-722-1000 Fax: 505-722-1268 | |
Ramona V. Anderson, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 516 East Nizhoni Blvd., Gallup, NM 87301 Phone: 505-722-1000 Fax: 505-722-1268 | |
Dr. John Edward Ratmeyer, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 516 Nizhoni Blvd, Gallup, NM 87301 Phone: 505-722-1000 Fax: 505-722-1268 | |
Michelle Stam-maclaren, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2111 College Drive, Rehoboth Mckinley Christian Health Care Services, Gallup, NM 87301 Phone: 505-863-1820 | |
Janet M Li-tempest, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 516 Nizhoni Blvd, Gallup, NM 87301 Phone: 505-722-1000 Fax: 505-722-1268 | |
Gary A Escudero, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 516 E. Nizhoni Blvd, Box 1337, Gallup, NM 87301 Phone: 505-722-1000 Fax: 505-722-1397 | |
Dr. Gayle Ann Harrison, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 2111 College Dr, Gallup, NM 87301 Phone: 505-863-1820 Fax: 505-863-1898 |