Individual
SHAVONNE TRUONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4420 IRVING BLVD NW, ALBUQUERQUE, NM 87114-5915
(505) 727-6300
Mailing address
4420 IRVING BLVD NW, ALBUQUERQUE, NM 87114-5915
(505) 727-6300
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
69751
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1083802029
FAMILY MEDICINE, PC
NM
Enumeration date
06/09/2021
Last updated
02/27/2024
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