Milagro Medical Group Pc

LBN: Milagro Medical Group Pc
Milagro Medical Group Pc is an health care organization with primary practice located at 504 Elm St Ne , Albuquerque NM 87102-2512. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Hospitalist, which is considered as the primary health care specialty. Milagro Medical Group Pc can be contacted via phone (505) 724-2005, or through Gonzales, David A via phone (505) 577-8282.

Contact Information

Primary practice address
504 Elm St Ne Albuquerque NM 87102-2512
Phone: (505) 724-2005
Fax: (505) 843-2931
Website:
Map and Directions
Authorized official contact:
Name: Gonzales, David A Doctor of Medicine (MD)
Phone: (505) 577-8282

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X PT0047621 FA0044101 New Mexico

Profile Details

NPI number 1548265713
LBN Legal business name Milagro Medical Group Pc
DBA Doing business as
Authorized official Gonzales, David A Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jun 15th, 2005
Last updated Sep 7th, 2010 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548265713 NPPES
New Mexico MEDICAID 30426529

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