Provider Demographics
NPI:1669692521
Name:BLAUGRUND, ALAN CHARLES (MD)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:CHARLES
Last Name:BLAUGRUND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 BIG HORN RIDGE DR NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87122-1454
Mailing Address - Country:US
Mailing Address - Phone:505-797-7610
Mailing Address - Fax:
Practice Address - Street 1:321 BIG HORN RIDGE DR NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87122-1454
Practice Address - Country:US
Practice Address - Phone:505-797-7610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM70-106207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology