Organization
SOUTHWEST WOMEN'S SONOGRAPHY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY REUSS M.D. (OWNER)
(505) 884-9687
Entity
Organization
Contact information
Practice address
4600 MONTGOMERY BLVD NE, BUILDING A, SUITE 101, ALBUQUERQUE, NM 87109-1210
(505) 884-9687
(505) 884-9688
Mailing address
PO BOX 2160, CORRALES, NM 87048-2160
(505) 884-9687
(505) 884-9688
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
2003-0502
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00NM009L79
BLUE CROSS BLUE SHIELD
NM
01
—
201045136
PREBYTERIAN HEALTH PLAN
NM
05
—
53157532
—
NM
01
—
P 12036477
MULTIPLAN
NM
Enumeration date
12/03/2006
Last updated
08/06/2009
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