Provider Demographics
NPI:1578598504
Name:CONLON, CHRISTOPHER P (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:P
Last Name:CONLON
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
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 1:8800 MONTGOMERY BLVD NE
Practice Address - Street 2:PMG MONTGOMERY
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-2310
Practice Address - Country:US
Practice Address - Phone:505-462-6400
Practice Address - Fax:505-462-6506
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2015-12-16
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Provider Licenses
StateLicense IDTaxonomies
NM95211207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMH6243Medicaid
NMH6243Medicaid
347710101Medicare PIN