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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
207RI0200X
Infectious Disease Physician
Primary
FA0003189
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CG7958
RR MEDICARE #
NM
05
K4066
NM
Enumeration date
11/28/2006
Last updated
04/24/2026
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