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Contact Information

MICHELLE STAM MACLAREN, MD
2111 COLLEGE DRIVE
REHOBOTH MCKINLEY CHRISTIAN HEALTH CARE SERVICES
GALLUP, NM87301
 Phone: 505-863-1820
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

208000000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for MICHELLE STAM MACLAREN · (Female)

NPI # 1104898063
Status Active
Credentials MD
Entity Individual
Enumeration date 02/06/2006
Last updated 07/09/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • NM License # 98-397
  • AZ Medicaid 433235
  • NM Medicaid S7386
  • Other 85031326887301A127 CHAMPUS
  • NM Other NM004611 BCBS
  • NM Other 10002353 LOVELACE HEALTH/SALUD
  • NM Other PROVP16359 MOLINA
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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