Provider Demographics
NPI:1669053674
Name:BRITTINGHAM, ZACHARY DAVID (DO)
Entity type:Individual
Prefix:
First Name:ZACHARY
Middle Name:DAVID
Last Name:BRITTINGHAM
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4101 CENTRAL AVE NE APT 4014
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87108-1966
Mailing Address - Country:US
Mailing Address - Phone:410-382-8082
Mailing Address - Fax:
Practice Address - Street 1:MSC10 5620
Practice Address - Street 2:1 UNIVERSITY OF NEW MEXICO
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:81731
Practice Address - Country:US
Practice Address - Phone:505-272-3160
Practice Address - Fax:505-272-9427
Is Sole Proprietor?:No
Enumeration Date:2021-04-20
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NMDO2023-1085208D00000X
NJ390200000X
NM0000390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice