Headley, Peter Abraham

Headley, Peter Abraham is an individual health care provider with primary practice located at 610 Broadway Blvd Ne , Albuquerque NM 87102-2372. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Urology, Other Service Providers / Specialist. Allopathic & Osteopathic Physicians / Urology is his primary health care specialty. Headley, Peter Abraham can be contacted via phone (505) 242-3991.

Contact Information

Primary practice address
610 Broadway Blvd Ne Albuquerque NM 87102-2372
Phone: (505) 242-3991
Fax: (505) 243-8405
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X MD2013-0794 New Mexico
Other Service Providers / Specialist 174400000X MD2013-0794 New Mexico

Profile Details

NPI number 1134394430
LBN Legal business name Headley, Peter Abraham
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 28th, 2008
Last updated Apr 21st, 2021 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134394430 NPPES
New Mexico Other MD2013-0794 MEDICAL LICENSE
New Mexico MEDICAID 6305351 MEDICAL LICENSE

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