Organization
INTERVENTIONAL PAIN SPECIALISTS OF NEW MEXICO, P.A.
Active
Organization
INTERVENTIONAL PAIN SPECIALISTS OF NEW MEXICO, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES F. PACE M.D. (PRESIDENT)
(505) 898-1595
Entity
Organization
Contact information
Practice address
4824 MCMAHON BLVD NW, SUITE 119, ALBUQUERQUE, NM 87114-5412
(505) 898-1595
Mailing address
4824 MCMAHON BLVD NW, SUITE 119, ALBUQUERQUE, NM 87114-5412
(505) 898-1595
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
2000-259
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
61727369
—
NM
01
—
NM009L89
BLUE CROSS BLUE SHIELD
NM
Enumeration date
01/26/2007
Last updated
08/22/2020
Update your record
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