Individual
DR. YAHUZA SIBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1100 LEAD AVE SE, ALBUQUERQUE, NM 87106-5215
(505) 224-7000
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD2017-0043
NM
207RG0100X
Gastroenterology Physician
Primary
MD2017-0043
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
85083852
—
NM
Enumeration date
08/10/2012
Last updated
07/21/2022
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