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Individual

MARGARET M WOLAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
6100 PAN AMERICAN NE, PMG OB/GYN NORTHSIDE, ALBUQUERQUE, NM 87109-3427
(505) 864-5454
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-5356
(505) 923-5354

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
79-306
NM
207VX0000X
Obstetrics Physician
79306
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5447
NM
Enumeration date
10/03/2006
Last updated
01/03/2019
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