Individual
ALAN MANNHEIMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
407 S SCHWARTZ AVE STE 201, FARMINGTON, NM 87401-5925
(505) 609-6700
(505) 609-2259
Mailing address
104 QUAIL TRAIL, UNIT B, EDGEWOOD, NM 87015
(505) 208-0204
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
0101277209
VA
208000000X
Pediatrics Physician
Primary
2003-0483
NM
208000000X
Pediatrics Physician
2013-00527
NC
2080P0203X
Pediatric Critical Care Medicine Physician
A95367
CA
2080P0203X
Pediatric Critical Care Medicine Physician
ME114820
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007868100
—
FL
05
—
1679717789
—
NC
05
—
NC2050
—
SC
Enumeration date
04/21/2009
Last updated
10/30/2024
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