Individual
FREDERICK FIBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
401 EDITH BLVD NE, ALBUQUERQUE, NM 87102-2509
(505) 243-8030
(505) 842-1158
Mailing address
401 EDITH BLVD NE, ALBUQUERQUE, NM 87102-2509
(505) 243-8030
(505) 842-1158
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
79-103
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201003032
PRESBYTERIAN HEALTH PLAN
NM
05
—
22723
—
NM
01
—
NM011153
BCBS
NM
Enumeration date
10/06/2005
Last updated
04/07/2010
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