Individual
JENNIE WEI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
516 E. NIZHONI BLVD., GALLUP, NM 87305-1337
(505) 722-1000
(505) 726-8557
Mailing address
P.O. BOX 1337, GALLUP, NM 87305-1337
(505) 722-1000
(505) 726-8557
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A112698
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/15/2009
Last updated
09/18/2012
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