Individual
LAURA MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4700 JEFFERSON ST NE, ALBUQUERQUE, NM 87109-2136
(505) 925-7464
Mailing address
1311A N MILDRED RD, CORTEZ, CO 81321-2231
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
34874
CO
208600000X
Surgery Physician
Primary
MD2016-0284
NM
Other
Enumeration date
01/30/2009
Last updated
07/05/2024
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