| Family Medicine Associates | |
|
517 Nizhoni Blvd Gallup NM 87301-5757 | |
| (505) 722-6603 | |
| (505) 722-6111 |
| Full Name | Family Medicine Associates |
|---|---|
| Speciality | Family Medicine |
| Location | 517 Nizhoni Blvd, Gallup, New Mexico |
| Authorized Official Name and Position | Susie Fronterotta (MANAGER) |
| Authorized Official Contact | 5057226603 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Medicine Associates 517 Nizhoni Blvd Gallup NM 87301-5757 Ph: (505) 722-6603 | Family Medicine Associates 517 Nizhoni Blvd Gallup NM 87301-5757 Ph: (505) 722-6603 |
| NPI Number | 1831330364 |
|---|---|
| Provider Enumeration Date | 03/12/2009 |
| Last Update Date | 07/13/2010 |
| Medicare PECOS PAC ID | 0042361883 |
|---|---|
| Medicare Enrollment ID | O20090708000018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831330364 | NPI | - | NPPES |
| 89721039 | Medicaid | NM | |
| QMP000003701894 | Other | NM | MOLINA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 2003-0154 (New Mexico) | Primary |
| Provider Name | Lawrence Andrade |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619955176 PECOS PAC ID: 2365355872 Enrollment ID: I20031111000236 |
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