Individual
MIRANDA VELIKOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5550 WYOMING BLVD NE, FAMILY MEDICINE, ALBUQUERQUE, NM 87109-3167
(505) 462-6600
(505) 462-6641
Mailing address
2001 CENTRO FAMILIAR BLVD SW, ALBUQUERQUE, NM 87105-4592
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD2020-0244
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30832811
—
NM
Enumeration date
04/06/2017
Last updated
11/21/2023
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