Provider Demographics
NPI:1922190040
Name:PACE, CHARLES F (MD)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:F
Last Name:PACE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4824 MCMAHON BLVD NW
Mailing Address - Street 2:SUITE 119
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87114-5412
Mailing Address - Country:US
Mailing Address - Phone:505-898-1595
Mailing Address - Fax:505-898-0846
Practice Address - Street 1:4824 MCMAHON BLVD NW
Practice Address - Street 2:SUITE 119
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87114-5412
Practice Address - Country:US
Practice Address - Phone:505-898-1595
Practice Address - Fax:505-898-0846
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2023-08-24
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Provider Licenses
StateLicense IDTaxonomies
NM2000-259207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMNM009L89OtherBCBS
NM201048060OtherPRESBYTERIAN HEALTH PLAN
NM61727369Medicaid