Individual
PAVEL JOHN NOCKEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O
Contact information
Practice address
8300 CONSTITUTION AVE NE, ALBUQUERQUE, NM 87110-7613
(505) 291-5330
(505) 291-2949
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
A-2097-17
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
27553272
—
NM
Enumeration date
04/15/2010
Last updated
11/02/2017
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