Individual
DAVID FILLMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8020 CONSTITUTION PL NE, STE 101, ALBUQUERQUE, NM 87110-7640
(505) 998-1317
(505) 998-1308
Mailing address
8020 CONSTITUTION PL NE, STE 202, ALBUQUERQUE, NM 87110-7640
(505) 998-3096
(505) 998-3100
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD2008-0074
NM
2085R0204X
Vascular & Interventional Radiology Physician
MD2008-0074
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000E7354
—
NM
Enumeration date
12/05/2005
Last updated
04/23/2025
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