Provider Demographics
NPI:1508060351
Name:SADLER, CORINN MELISSA (MD)
Entity Type:Individual
Prefix:DR
First Name:CORINN
Middle Name:MELISSA
Last Name:SADLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CORINN
Other - Middle Name:MELISSA
Other - Last Name:CHIVINGTON-BUCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 26666
Mailing Address - Street 2:PHS PROVIDER ENROLLMENT
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87125-6666
Mailing Address - Country:US
Mailing Address - Phone:505-923-6770
Mailing Address - Fax:505-923-5354
Practice Address - Street 1:4100 HIGH RESORT BLVD SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87124
Practice Address - Country:US
Practice Address - Phone:505-559-6400
Practice Address - Fax:505-559-6488
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2018-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO51433207RE0101X
NMMD2018-0156207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism