Individual
STACEY CLEGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
502 ELM ST NE, ALBUQUERQUE, NM 87102-2512
(505) 841-1000
Mailing address
800 BRADBURY DR SE STE 116, ALBUQUERQUE, NM 87106-4310
(505) 272-1476
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
MD2013-0398
NM
207RI0011X
Interventional Cardiology Physician
MD2013-0398
NM
Other
Enumeration date
12/21/2007
Last updated
01/30/2025
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