Individual
DR. FREDIE C DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3900 LAS ESTANCIAS CT SW, ALBUQUERQUE, NM 87121
(505) 727-4200
(505) 727-4949
Mailing address
3900 LAS ESTANCIAS CT SW, ALBUQUERQUE, NM 87121
(505) 727-4200
(505) 727-4949
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
199224
NY
207R00000X
Internal Medicine Physician
Primary
MD2016-0863
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01752607
—
NY
01
—
7855020
AETNA
NY
01
—
OX7112
EMPIRE BC.BS
NY
Enumeration date
07/12/2006
Last updated
03/28/2017
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