Organization
RIO GRANDE DERMATOLOGY, PC
Active
Organization
RIO GRANDE DERMATOLOGY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. FRANCINE O MONTANO (PRACTICE MANAGER)
(505) 896-2900
Entity
Organization
Contact information
Practice address
4545 ALAMEDA BLVD NE, SUITE G, ALBUQUERQUE, NM 87113-1591
(505) 896-2900
(505) 938-4198
Mailing address
4545 ALAMEDA BLVD NE, SUITE G, ALBUQUERQUE, NM 87113-1591
(505) 896-2900
(505) 938-4198
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
20020450
NM
207N00000X
Dermatology Physician
20050405
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47235306
—
NM
05
—
76659755
—
NM
Enumeration date
07/25/2008
Last updated
02/05/2015
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