Provider Demographics
NPI:1700029386
Name:DEBASSIGE, NATALIE DAWN (MD)
Entity Type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:DAWN
Last Name:DEBASSIGE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3436 ISLETA BLVD
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87105-1300
Mailing Address - Country:US
Mailing Address - Phone:505-462-7777
Mailing Address - Fax:
Practice Address - Street 1:3436 ISLETA BLVD
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87105-1300
Practice Address - Country:US
Practice Address - Phone:505-462-7777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-13
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD20120639207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine