Individual
DR. PATRICIA BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4701 MONTGOMERY BLVD NE, ALBUQUERQUE, NM 87109-1219
(505) 727-7800
Mailing address
4101 INDIAN SCHOOL RD NE STE 110, ALBUQUERQUE, NM 87110-3991
(505) 727-4500
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MD2020-1147
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD2022-1147
NEW MEXICO MEDICAL LICENSE
NM
Enumeration date
03/26/2018
Last updated
10/25/2022
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