Individual
MELANIE M UKANWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4253 MONTGOMERY BLVD NE STE 220, ALBUQUERQUE, NM 87109-1130
(505) 881-5307
(505) 908-3816
Mailing address
PO BOX 27453, ALBUQUERQUE, NM 87125-7453
(505) 881-5307
(505) 908-3816
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD20060291
NM
207QA0401X
Addiction Medicine (Family Medicine) Physician
MD20060291
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
17670721
—
NM
01
—
NMAAA2194
MEDICARE PTAN
—
Enumeration date
06/10/2006
Last updated
10/24/2025
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