Individual
ANGELA GALLEGOS-MACIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
PMG ISLETA, 3436 ISLETA BLVD SW, ALBUQUERQUE, NM 87105
(505) 462-7777
(505) 462-7880
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-5356
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD2004-0084
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31651500
—
NM
Enumeration date
08/31/2005
Last updated
08/14/2008
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