Provider Demographics
NPI:1164455663
Name:SAWYER, ALISON M (MD)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:M
Last Name:SAWYER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1751 OLD PECOS TRL STE I
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-4706
Mailing Address - Country:US
Mailing Address - Phone:505-227-6956
Mailing Address - Fax:
Practice Address - Street 1:1751 OLD PECOS TRL STE I
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-4706
Practice Address - Country:US
Practice Address - Phone:505-227-6956
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-08
Last Update Date:2009-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2002-0209207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM22828842Medicaid
NM341312502Medicare ID - Type Unspecified
NM22828842Medicaid