Individual
BEVERLY A PUCKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1001 COAL AVE SE, ALBUQUERQUE, NM 87106-5205
(505) 843-6168
(505) 792-1978
Mailing address
6320 RIVERSIDE PLAZA LN NW STE B, ALBUQUERQUE, NM 87120-1710
(505) 843-6168
(505) 792-1978
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
86107
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
37325
—
NM
Enumeration date
08/23/2006
Last updated
05/23/2018
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