Provider Demographics
NPI:1578719209
Name:NEW MEXICO INNER WELLNESS CENTER, INC
Entity Type:Organization
Organization Name:NEW MEXICO INNER WELLNESS CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIAN
Authorized Official - Middle Name:F
Authorized Official - Last Name:ROWE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:505-884-8900
Mailing Address - Street 1:6801 JEFFERSON ST NE
Mailing Address - Street 2:SUITE 350
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-4379
Mailing Address - Country:US
Mailing Address - Phone:505-884-8900
Mailing Address - Fax:888-699-4725
Practice Address - Street 1:6801 JEFFERSON ST NE
Practice Address - Street 2:SUITE 350
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-4379
Practice Address - Country:US
Practice Address - Phone:505-884-8900
Practice Address - Fax:888-699-4725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-13
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM97-136207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty