Individual
MR. ADAM HENRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
123 MADEIRA DR SE, ALBUQUERQUE, NM 87108-2963
(505) 262-1538
Mailing address
215 LEAD AVE SW APT 1308, ALBUQUERQUE, NM 87102-4080
(505) 274-6611
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2022-0108
NM
Other
Enumeration date
09/07/2018
Last updated
10/26/2022
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