Provider Demographics
NPI:1356435721
Name:GARCIA, MELISSA M (MD)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:M
Last Name:GARCIA
Suffix:
Gender:F
Credentials:MD
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 26666
Mailing Address - Street 2:PHS PROVIDER ENROLLMENT
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87125-6666
Mailing Address - Country:US
Mailing Address - Phone:505-923-5356
Mailing Address - Fax:505-923-5354
Practice Address - Street 1:8200 CONSTITUTION PL NE STE A
Practice Address - Street 2:PMG KASEMAN FAMILY HEALTHCARE
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-7647
Practice Address - Country:US
Practice Address - Phone:505-841-1063
Practice Address - Fax:505-222-2695
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2013-03-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NM98268207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMZ6116Medicaid
NMZ6116Medicaid
5855456859PMedicare PIN