Individual
DEBORAH A GRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
5901 HARPER DR NE, PMG URGENT CARE, ALBUQUERQUE, NM 87109-3587
(505) 823-8233
(505) 823-8243
Mailing address
PO BOX 26666, PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A-106496
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
72101
—
NM
Enumeration date
08/30/2006
Last updated
06/10/2019
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