Provider Demographics
NPI:1629210869
Name:AUYANG, EDWARD D (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:D
Last Name:AUYANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:933 BRADBURY DR SE STE 2222
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-4375
Mailing Address - Country:US
Mailing Address - Phone:505-272-1320
Mailing Address - Fax:505-272-8060
Practice Address - Street 1:UNM SURGICAL SPECIALTIES CLINIC 2211 LOMAS BLVD NE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87131-0001
Practice Address - Country:US
Practice Address - Phone:505-272-2336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-02
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.121894208600000X
NMMD2012-0347208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery