Individual
MARCHELL R WOODRUFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
101 HOSPITAL LOOP NE STE 201, ALBUQUERQUE, NM 87109-2128
(505) 727-4430
Mailing address
101 HOSPITAL LOOP NE STE 201, ALBUQUERQUE, NM 87109-2128
(505) 727-4430
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2014-0059
NM
363AM0700X
Medical Physician Assistant
PA2014-0059
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
81128827
—
NM
Enumeration date
10/23/2014
Last updated
04/27/2023
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