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Organization
MILAGRO MEDICAL GROUP PC
Active
Organization
MILAGRO MEDICAL GROUP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID A GONZALES MD (PRESIDENT - OWNER)
(505) 577-8282
Entity
Organization
Contact information
Practice address
504 ELM ST NE, ALBUQUERQUE, NM 87102-2512
(505) 724-2005
(505) 843-2931
Mailing address
314 W HOUGHTON ST, SANTA FE, NM 87505-8849
(505) 577-8282
(505) 843-2931
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
PT0047621 FA0044101
NM
Other
Enumeration date
06/15/2005
Last updated
09/07/2010
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