Zachary, Vance Edward

Zachary, Vance Edward is an individual health care provider with primary practice located at 4420 Irving Blvd Nw , Albuquerque NM 87114-5915. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Zachary, Vance Edward can be contacted via phone (505) 727-6300.

Contact Information

Primary practice address
4420 Irving Blvd Nw Albuquerque NM 87114-5915
Phone: (505) 727-6300
Fax: (505) 727-9588
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X G7610 Texas
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X G7610 Texas
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD2015-0091 New Mexico

Profile Details

NPI number 1295796480
LBN Legal business name Zachary, Vance Edward
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 29th, 2006
Last updated Feb 5th, 2016 - about 9 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 1295796480 NPPES
New Mexico Other 401311YR41 MEDICARE NUMBER
New Mexico MEDICAID 25156772 MEDICARE NUMBER

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