Individual
ANNA LISE KOENIG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3001 BROADMOOR BLVD NE, RIO RANCHO, NM 87144-2100
(505) 994-7000
Mailing address
800 BRADBURY DR SE STE 116, ALBUQUERQUE, NM 87106-4310
(505) 272-1476
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD2020-0942
NM
Other
Enumeration date
04/14/2015
Last updated
04/02/2025
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