| James M. Wilterding, M.d., Llc | |
|
711 Encino Pl Ne Suite D Albuquerque NM 87102-2619 | |
| (505) 265-2244 | |
| (505) 265-0557 |
| Full Name | James M. Wilterding, M.d., Llc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 711 Encino Pl Ne, Albuquerque, New Mexico |
| Authorized Official Name and Position | James M. Wilterding (OWNER) |
| Authorized Official Contact | 5052652244 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| James M. Wilterding, M.d., Llc 711 Encino Pl Ne Suite D Albuquerque NM 87102-2619 Ph: (505) 265-2244 | James M. Wilterding, M.d., Llc 711 Encino Pl Ne Suite D Albuquerque NM 87102-2619 Ph: (505) 265-2244 |
| NPI Number | 1174622666 |
|---|---|
| Provider Enumeration Date | 09/21/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174622666 | NPI | - | NPPES |
| 61238015 | Medicaid | NM | |
| PROVP16828 | Other | NM | MOLINA SALUD |
| NM009M95 | Other | NM | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 2003-0249 (New Mexico) | Primary |
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