Individual
JEAN SHIMANEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
101 HOSPITAL LP NE, STE 214, ALBUQ, NM 87109-2128
(505) 883-6600
(505) 883-0023
Mailing address
101 HOSPITAL LP NE, STE 214, ALBUQ, NM 87109-2128
(505) 883-6600
(505) 883-0023
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
91307
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2086S0122X
—
NM
01
—
741440546305
TRIWEST
NM
05
—
E2086
—
NM
Enumeration date
06/06/2006
Last updated
05/20/2008
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