National Provider Identifier Database

ANIMAS DERMATOLOGY MD PC
Specialist

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.


Contact Information

ANIMAS DERMATOLOGY MD PC
4801 N BUTLER AVE STE 9101
FARMINGTON, NM87401-3300
Phone: 505-324-8375
Fax: 505-327-4638
Website:
Specialty Taxonomy Code
* Specialist 174400000X

* Indicates primary specialty

NPI Profile & details for ANIMAS DERMATOLOGY MD PC

NPI Number 1063576148
Legal business name
LBN
ANIMAS DERMATOLOGY MD PC
Authorized official JEAN GRAHAM - (CEO)
Entity Organization
Organization subpart No
Enumeration date 12/21/2006
Last updated 08/17/2018 - About 8 years ago
Sole proprietor1 Not specified
Identifiers
  • NM License #: 97-254
  • NM Medicaid: Q2833
  • NM Other: NM012425 BLUE CROSS BLUE SHIELD NM

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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