Individual
GREGORY P MANOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
PMG URGENT CARE, 5901 HARPER DRIVE NE, ALBUQUERQUE, NM 87109
(505) 823-8519
(505) 823-8355
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
91-248
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000E2595
—
NM
Enumeration date
05/12/2006
Last updated
08/14/2008
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