Individual
EDGAR C. BOEDEKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1001 DR MARTIN LUTHER KING JR AVE NE, ALBUQUERQUE, NM 87106-4713
(505) 925-6000
(505) 272-8018
Mailing address
1001 DR MARTIN LUTHER KING JR AVE NE, ALBUQUERQUE, NM 87106-4713
(505) 925-6000
(505) 272-8018
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
MD2005-0398
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43351841
—
CO
05
—
46554548
—
NM
05
—
989444
—
AZ
Enumeration date
10/03/2006
Last updated
05/17/2012
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