Individual
PERCY M PENTECOST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3016 MACKLAND AVE NE, ALBUQUERQUE, NM 87106-2018
(505) 399-0890
(505) 448-0778
Mailing address
3016 MACKLAND AVE NE, ALBUQUERQUE, NM 87106-2018
(505) 399-0890
(505) 448-0778
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
MD2004-0754
NM
207R00000X
Internal Medicine Physician
MD2004-0754
NM
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
MD2004-0754
NM
Other
Enumeration date
09/27/2005
Last updated
02/15/2021
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