Organization
NEW MEXICO RHEUMATOLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER ANTHONY ROSANDICH MD (MEDICAL DIRECTOR)
(404) 759-6866
Entity
Organization
Contact information
Practice address
8200 LOUISIANA BLVD NE, ALBUQUERQUE, NM 87113-2105
(505) 828-2400
Mailing address
8200 LOUISIANA BLVD NE, ALBUQUERQUE, NM 87113-2105
(505) 828-2400
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
MD20050123
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1356435747
NPI-PERSONAL
—
05
—
78834295
—
NM
Enumeration date
02/11/2010
Last updated
11/27/2010
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