Andrade, Aedra D.
Andrade, Aedra D. is an individual health care provider with primary practice located at 610 N 5Th St , Gallup NM 87301-5306. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Andrade, Aedra D. can be contacted via phone (505) 863-3120.Contact Information
Primary practice address
610 N 5Th St
Gallup NM 87301-5306
Phone: (505) 863-3120
Fax: (505) 863-2691
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | NM2003-0155 | New Mexico |
Profile Details
| NPI number | 1164435673 |
|---|---|
| LBN Legal business name | Andrade, Aedra D. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 14th, 2006 |
| Last updated | Aug 1st, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1164435673 | NPPES |
| New Mexico | MEDICAID | 16657055 |
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