Individual
EFFIE E MEDFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
104 QUAIL TRL UNIT B, EDGEWOOD, NM 87015-7185
(505) 208-0204
(505) 384-7028
Mailing address
104 QUAIL TRL UNIT B, EDGEWOOD, NM 87015-7185
(505) 208-0204
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
69-167
NM
Other
Enumeration date
03/22/2010
Last updated
05/04/2018
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