Provider Demographics
NPI:1043370554
Name:HUAMAN, ANA G (MD)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:G
Last Name:HUAMAN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:8100 WYOMING BLVD NE STE M4
Mailing Address - Street 2:PMB 293
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87113-1963
Mailing Address - Country:US
Mailing Address - Phone:505-266-8200
Mailing Address - Fax:505-256-7565
Practice Address - Street 1:3901 GEORGIA ST NE STE G-2
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-1359
Practice Address - Country:US
Practice Address - Phone:505-266-8200
Practice Address - Fax:505-256-7565
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2019-02-26
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Provider Licenses
StateLicense IDTaxonomies
NM90-213207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMNM009M96OtherBLUE CROSS BLUE SHIELD
NMP00163555OtherRAILROAD MEDICARE
NMQ7363Medicaid
NM201055717OtherPRESBYTERIAN HEALTH PLAN
NMPROVP13283OtherMOLINA HEALTH CARE
341410402Medicare ID - Type UnspecifiedINDIVIDUAL MEDICARE #
NMNM009M96OtherBLUE CROSS BLUE SHIELD
E63659Medicare UPIN
NMNM400281Medicare PIN