Individual
DAWN STUCKWISCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
11601 MONTGOMERY BLVD NE, ALBUQUERQUE, NM 87111-2660
(505) 814-1995
Mailing address
11601 MONTGOMERY BLVD NE, ALBUQUERQUE, NM 87111-2660
(505) 814-1995
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01054092
IN
207P00000X
Emergency Medicine Physician
Primary
MD2020-1061
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200341050
—
IN
Enumeration date
08/09/2006
Last updated
12/09/2020
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