Organization
EDGEWOOD PEDIATRIC CLINIC L.L.C.
Active
Organization
EDGEWOOD PEDIATRIC CLINIC L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHARON DIANE GARNAND MD (OWNER)
(505) 281-4620
Entity
Organization
Contact information
Practice address
2 EUNICE CT BLDG B, EDGEWOOD, NM 87015-9108
(505) 281-4620
(505) 281-0397
Mailing address
PO BOX 1320, EDGEWOOD, NM 87015-1320
(505) 281-4620
(505) 281-0397
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2003-0092
NM
Other
Enumeration date
07/21/2009
Last updated
05/30/2012
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