Organization
FAMILY MEDICINE ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUSIE FRONTEROTTA (MANAGER)
(505) 722-6603
Entity
Organization
Contact information
Practice address
517 NIZHONI BLVD, GALLUP, NM 87301-5757
(505) 722-6603
(505) 722-6111
Mailing address
517 NIZHONI BLVD, GALLUP, NM 87301-5757
(505) 722-6603
(505) 722-6111
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2003-0154
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89721039
—
NM
01
—
QMP000003701894
MOLINA
NM
Enumeration date
03/12/2009
Last updated
07/13/2010
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