Organization
ALBUQUERQUE INTERNAL MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM OLIVER BERLIN II M.D. (PHYSICIAN)
(505) 314-0748
Entity
Organization
Contact information
Practice address
4121 MONTGOMERY BLVD NE, ALBUQUERQUE, NM 87109-1102
(505) 314-0748
Mailing address
4101 BLUE RIDGE PL NE, ALBUQUERQUE, NM 87111-4166
(505) 314-0748
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00013372
—
NM
01
—
DD1175
RAILROAD MEDICARE
—
01
—
NM019U17
BLUE CROSS BLUE SHIELD
—
Enumeration date
11/09/2006
Last updated
11/14/2012
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