Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 4301103791 | MI |
N | 208600000X | Surgeon | 4301103791 | MI |
Y | 208D00000X | General Practice Physician | MD 2015-0613 | NM |
NPI | 1033487319 |
---|---|
Provider Name | Ana Paula De Oliveira Pereira |
First Address | Albuquerque, NM 87109-5832 |
Second Address | Albuquerque, NM 87109-5832 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2011 |
Last Update Date | 19/10/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
MD 2015-0613 | MEDICAL STATE LICENSE (01) | NM |
RS2014-0636 | NEW MEXICO STATE MEDICAL BOARD (01) | NM |