Provider Demographics
NPI:1750316865
Name:GRIEBLER, CYNTHIA HELEN (MD)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:HELEN
Last Name:GRIEBLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 26028
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87125-6028
Mailing Address - Country:US
Mailing Address - Phone:505-262-7915
Mailing Address - Fax:505-232-1627
Practice Address - Street 1:500 WALTER ST NE STE 510
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-2567
Practice Address - Country:US
Practice Address - Phone:505-262-3542
Practice Address - Fax:505-262-7394
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NMMD20050599207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM48972789Medicaid
H72565Medicare UPIN