Organization
PRN MEDICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GABRIELE STILLER MD (MEDICAL DIRECTOR)
(505) 627-9350
Entity
Organization
Contact information
Practice address
1717 W 2ND ST, SUITE 115, ROSWELL, NM 88201-2000
(505) 627-5700
(505) 627-9419
Mailing address
1717 W 2ND ST, SUITE 115, ROSWELL, NM 88201-2000
(505) 627-5700
(505) 627-9419
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
B8576
—
NM
Enumeration date
05/02/2007
Last updated
11/23/2010
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