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Individual

MARCI C GAMBAROTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
516 E. NIZHONI BLVD., GALLUP, NM 87301-1337
(505) 722-1000
(505) 722-1310
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
(505) 923-5354

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD2006-0438
NM
207P00000X
Emergency Medicine Physician
MD424787
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
76226239
NM
05
961567
AZ
Enumeration date
06/21/2006
Last updated
02/02/2018
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