Organization
BUZYKE ALLIANCE LLC
Active
Other names
Major Consult Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHIBUZO UKAEGBU M.D. (OWNER/MEDICAL DIRECTOR)
(575) 556-9837
Entity
Organization
Contact information
Practice address
3885 FOOTHILLS RD, SUITE B, LAS CRUCES, NM 88011-4672
(575) 556-9837
Mailing address
PO BOX 13969, LAS CRUCES, NM 88013-3969
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
MD2008-0255
NM
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
MD2008-0255
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
16678818
—
NM
Enumeration date
04/06/2014
Last updated
07/07/2018
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