Provider Demographics
NPI:1497933493
Name:STOESSER, ANNETTE ROSE (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNETTE
Middle Name:ROSE
Last Name:STOESSER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:112 S KENTUCKY AVE
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:NM
Mailing Address - Zip Code:88203-4519
Mailing Address - Country:US
Mailing Address - Phone:575-623-2444
Mailing Address - Fax:575-622-2814
Practice Address - Street 1:112 S KENTUCKY AVE
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:NM
Practice Address - Zip Code:88203-4519
Practice Address - Country:US
Practice Address - Phone:575-623-2444
Practice Address - Fax:575-622-2814
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-01
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM73-76207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMC98118Medicare UPIN