Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 036-086121 | IL |
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 036-086121 | IL |
NPI | 1093799256 |
---|---|
Provider Name | Dr. Miriam I Redleaf |
First Address | Albuquerque, NM 87106-2719 |
Second Address | Albuquerque, NM 87106-8710 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2005 |
Last Update Date | 29/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E29303 | (02) | IL |