Individual
CLIFFORD R STOLLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6100 SEAGULL ST NE, SUITE 106, ALBUQUERQUE, NM 87109-2500
(505) 883-4395
(505) 883-4397
Mailing address
6100 SEAGULL ST NE, SUITE 106, ALBUQUERQUE, NM 87109-2500
(505) 883-4395
(505) 883-4397
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
82-316
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000037341
—
NM
Enumeration date
07/31/2006
Last updated
07/09/2007
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