| University Of New Mexico Medical Group, Inc. | |
|
800 Odelia Rd Ne Albuquerque NM 87102-1619 | |
| (505) 244-1330 | |
| (505) 244-1331 |
| Full Name | University Of New Mexico Medical Group, Inc. |
|---|---|
| Speciality | Clinic/center - Student Health |
| Location | 800 Odelia Rd Ne, Albuquerque, New Mexico |
| Authorized Official Name and Position | Anthony Masciatra (CEO) |
| Authorized Official Contact | 5052728950 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| University Of New Mexico Medical Group, Inc. University Of New Mexico School Based Health Ctrs Msc09 5040 1 University Of New Mexico Albuquerque NM 87131-0001 Ph: (505) 272-0457 | University Of New Mexico Medical Group, Inc. 800 Odelia Rd Ne Albuquerque NM 87102-1619 Ph: (505) 244-1330 |
| NPI Number | 1992966923 |
|---|---|
| Provider Enumeration Date | 06/23/2008 |
| Last Update Date | 06/23/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992966923 | NPI | - | NPPES |
| 3A01 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QS1000X | Clinic/center - Student Health | 425 (New Mexico) | Primary |
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