Individual
JULIE K VAN SOMEREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
201 CEDAR ST SE STE 507, PMG OB HOSPITALIST, ALBUQUERQUE, NM 87106-4925
(505) 563-6381
(505) 563-6380
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-5356
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
97-396
NM
207VX0000X
Obstetrics Physician
97396
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000Q2119
—
NM
Enumeration date
10/03/2006
Last updated
06/24/2019
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