Individual
DR. STEPHANIE JEANNE RAEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
10511 GOLF COURSE RD NW, ALBUQUERQUE, NM 87114-5916
(505) 262-7281
(505) 262-7622
Mailing address
PO BOX 26028, ALBUQUERQUE, NM 87125-6028
(505) 262-7915
(505) 232-1627
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD2012-0648
NM
208600000X
Surgery Physician
RS2007-0352
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
27404820
—
NM
01
—
NMA102892
MEDICARE
NM
01
—
RS2007-0352
TRAINING LICENCE
NM
Enumeration date
06/27/2007
Last updated
01/28/2019
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