Organization
INFECTIOUS DISEASES AND INTERNAL MEDICINE ASSOCIATES P.C.
Active
Organization
INFECTIOUS DISEASES AND INTERNAL MEDICINE ASSOCIATES P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANIVA BACK (PRACTICE MANAGER)
(505) 848-3730
Entity
Organization
Contact information
Practice address
5901 HARPER DR NE, ALBUQUERQUE, NM 87109-3587
(505) 848-3730
(505) 848-3732
Mailing address
5901 HARPER DR NE BLDG 1, ALBUQUERQUE, NM 87109-3569
(505) 848-3730
(505) 848-3732
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
FA0003189
NM
207RI0200X
Infectious Disease Physician
Primary
FA0003189
NM
207RI0200X
Infectious Disease Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CG7958
RR MEDICARE #
NM
05
—
K4066
—
NM
Enumeration date
11/28/2006
Last updated
07/07/2026
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