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Individual

MIGUEL PELLERANO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
PMG AT 8300 CONSTITUTION - PULMONARY/CRITICAL CARE, 8300 CONSTITUTION AVE NE, ALBUQUERQUE, NM 87110
(505) 291-2100
(505) 291-2199
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-5356
(505) 923-5354

Taxonomy

Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
MD2006-0149
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
51434067
NM
Enumeration date
06/01/2006
Last updated
08/14/2008
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