Individual
PATRICIA NOVECK KONRAD
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1316 BLUMENSCHEIN RD, TAOS, NM 87571-6378
(505) 758-7876
Mailing address
1316 BLUMENSCHEIN RD, TAOS, NM 87571-6378
(505) 758-7876
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
20020061
NM
207ZP0101X
Anatomic Pathology Physician
A22569
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
891059U
—
NM
Enumeration date
08/31/2005
Last updated
07/08/2007
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