Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MD2017-0072 | NM |
N | 111NI0900X | Internist | MD2017-0072 | NM |
N | 207RA0401X | Internist - Addiction Medicine | 0101032883 | VA |
Y | 207RA0401X | Internist - Addiction Medicine | MD2017-0072 | NM |
NPI | 1174726582 |
---|---|
Provider Name | Dr. Patricia A Pade |
First Address | Albuquerque, NM 87125-6666 |
Second Address | Albuquerque, NM 87112-5046 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2007 |
Last Update Date | 09/03/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
43278248 | (05) | NM |