Provider Demographics
NPI:1851941330
Name:ABQ INTEGRATIVE FAMILY MEDICINE LLC
Entity Type:Organization
Organization Name:ABQ INTEGRATIVE FAMILY MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARCUS
Authorized Official - Middle Name:T
Authorized Official - Last Name:HIGI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:970-560-1389
Mailing Address - Street 1:3301R COORS BLVD NW # 292
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87120-1229
Mailing Address - Country:US
Mailing Address - Phone:970-560-1389
Mailing Address - Fax:
Practice Address - Street 1:4123 MONTGOMERY BLVD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-1102
Practice Address - Country:US
Practice Address - Phone:505-226-2300
Practice Address - Fax:833-996-1648
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-16
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty