Provider Demographics
NPI:1376545848
Name:BOEHRINGER, CHRISTINE (DO)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:
Last Name:BOEHRINGER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:
Other - Last Name:UBSDELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:D O
Mailing Address - Street 1:500 WALTER ST NE
Mailing Address - Street 2:STE 104
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87102-2534
Mailing Address - Country:US
Mailing Address - Phone:505-848-3730
Mailing Address - Fax:
Practice Address - Street 1:500 WALTER ST NE
Practice Address - Street 2:STE 104
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-2534
Practice Address - Country:US
Practice Address - Phone:505-848-3730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2020-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMA-1556-10207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM00AX70010Medicaid
NM00AX70010Medicaid