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Individual

ALBERT M KWAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1820 W 21ST ST, CLOVIS, NM 88101-4024
(575) 762-2207
(575) 762-7108
Mailing address
1820 W 21ST ST, CLOVIS, NM 88101-4024
(575) 762-2207
(575) 762-7108

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
89-340
NM
208600000X
Surgery Physician
Primary
89340
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
020045902
RAILROAD MEDICARE
NM
05
10585
NM
Enumeration date
11/08/2005
Last updated
04/04/2016
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