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Organization
NEW MEXICO FOOT AND ANKLE INSTITUTE PC
Active
Organization
NEW MEXICO FOOT AND ANKLE INSTITUTE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NATHAN D IVEY (OWNER)
(505) 880-1000
Entity
Organization
Contact information
Practice address
4343 PAN AMERICAN FWY NE STE 234, ALBUQUERQUE, NM 87107-6834
(505) 880-1000
(505) 880-1002
Mailing address
4343 PAN AMERICAN FWY NE STE 234, ALBUQUERQUE, NM 87107-6834
(505) 880-1000
(505) 880-1002
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10004402
LOVELACE
NM
01
—
201042850
PRASBYTERIAN
NM
05
—
8571325
—
NM
01
—
CK6674
RAILROAD MCR
—
01
—
NM005490
BLUE CROSS BLUE SHIELD
NM
01
—
PROVB11359
MOLINA
NM
Enumeration date
11/22/2006
Last updated
05/30/2023
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