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Individual

DR. POLLY C. PRIMM

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1100 CENTRAL AVE SE, ALBUQUERQUE, NM 87106-4930
(505) 841-1234
(505) 841-1956
Mailing address
1720 LOUISIANA BLVD NE, STE 401, ALBUQUERQUE, NM 87110-7020
(505) 260-4300
(505) 260-4338

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
97-125
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
23934
NM
05
380288
AZ
05
90182031
CO
01
NM009C79
BLUE CROSS BLUE SHEILD
NM
05
P4031
NM
Enumeration date
05/27/2005
Last updated
07/09/2007
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