Provider Demographics
NPI:1922017730
Name:NAGEL, BARRY D (MD)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:D
Last Name:NAGEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1020 TIJERAS AVE NE
Mailing Address - Street 2:STE 22
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-4749
Mailing Address - Country:US
Mailing Address - Phone:505-848-3124
Mailing Address - Fax:505-727-9590
Practice Address - Street 1:1020 TIJERAS AVE NE
Practice Address - Street 2:SUITE 22
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-4749
Practice Address - Country:US
Practice Address - Phone:505-848-3124
Practice Address - Fax:505-848-8077
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NM78-230207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMNM003124OtherBCBS ID
NM040012235OtherRR MEDICARE ID
NM13201Medicaid