St Jude Medical Center Corp | |
400 Gold Ave Sw Ste 220 Albuquerque NM 87102-3278 | |
(682) 309-8936 | |
Not Available |
Full Name | St Jude Medical Center Corp |
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Speciality | General Practice |
Location | 400 Gold Ave Sw Ste 220, Albuquerque, New Mexico |
Authorized Official Name and Position | Uyama A Fernandez (PRESIDENT) |
Authorized Official Contact | 6823098936 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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St Jude Medical Center Corp 400 Gold Ave Sw Ste 220 Albuquerque NM 87102-3278 Ph: (682) 309-8936 | St Jude Medical Center Corp 400 Gold Ave Sw Ste 220 Albuquerque NM 87102-3278 Ph: (682) 309-8936 |
NPI Number | 1760038350 |
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Provider Enumeration Date | 08/10/2019 |
Last Update Date | 08/13/2019 |
Identifier | Type | State | Issuer |
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1760038350 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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208D00000X | General Practice | (* (Not Available)) | Primary |
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