Provider Demographics
NPI:1598804593
Name:PERALTA, MEL ANGEL (MD)
Entity Type:Individual
Prefix:DR
First Name:MEL
Middle Name:ANGEL
Last Name:PERALTA
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Gender:M
Credentials:MD
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Mailing Address - Street 1:502 ELM ST NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87102-2512
Mailing Address - Country:US
Mailing Address - Phone:505-841-1000
Mailing Address - Fax:505-843-2956
Practice Address - Street 1:2240 GRANDE BLVD SE
Practice Address - Street 2:SUITE 102
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-1751
Practice Address - Country:US
Practice Address - Phone:505-841-1000
Practice Address - Fax:505-843-2592
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2014-09-19
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Provider Licenses
StateLicense IDTaxonomies
NMMD2005-0581207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease