Individual
DR. FREDERICK M KULLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
433 SAINT MICHAELS DR, SANTA FE, NM 87505-7601
(505) 988-1232
(505) 984-1603
Mailing address
433 SAINT MICHAELS DR, SANTA FE, NM 87505-7601
(505) 988-1232
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
78-202
NM
207Q00000X
Family Medicine Physician
Primary
78-202
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10003854
LOVELACE HEALTH PLAN
—
05
—
13672
—
NM
01
—
1699938
UHC
—
01
—
202015408
PRESBYTERIAN HEALTH PLAN
—
05
—
44396
—
NM
01
—
NM011553
BCBS NM
NM
01
—
PROVP13502
MOLINA
—
Enumeration date
06/22/2005
Last updated
07/08/2013
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