Provider Demographics
NPI:1538333554
Name:FLEG, ANTHONY (MD, MPH)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:FLEG
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:933 BRADBURY DR SE
Mailing Address - Street 2:SUITE 2222
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-4374
Mailing Address - Country:US
Mailing Address - Phone:505-272-3120
Mailing Address - Fax:505-272-8060
Practice Address - Street 1:3001 BORADMOOR BLVD NE
Practice Address - Street 2:UNM SANDOVAL REGIONAL MEDICAL CENTER
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87144
Practice Address - Country:US
Practice Address - Phone:505-994-7000
Practice Address - Fax:505-552-5805
Is Sole Proprietor?:No
Enumeration Date:2008-04-22
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2011-0558207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMMD2011-0558OtherNEW MEXICO MEDICAL BOARD STATE LICENSE NUMBER
NMFF4331447OtherDEA#