| Dr Paula Renee Mora, MD | |
|
516 E Nizhoni Blvd, Gallup, NM 87301-5748 | |
| (505) 722-1482 | |
| (505) 722-1629 |
| Full Name | Dr Paula Renee Mora |
|---|---|
| Gender | Female |
| Speciality | General Practice |
| Location | 516 E Nizhoni Blvd, Gallup, New Mexico |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316915051 | NPI | - | NPPES |
| 21657025 | Medicaid | NM | |
| 769614 | Other | NM | AHCCCS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 29216 (Arizona) | Primary |
| Entity Name | Dhhs,phs,naihs Gallup Indian Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1225002322 PECOS PAC ID: 3173436409 Enrollment ID: O20031111000840 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Paula Renee Mora, MD 516 E Nizhoni Blvd, Gallup, NM 87301-5748 Ph: (505) 722-1482 | Dr Paula Renee Mora, MD 516 E Nizhoni Blvd, Gallup, NM 87301-5748 Ph: (505) 722-1482 |
Dr. Cleora Shunkamolah, M.D. General Practice Medicare: Accepting Medicare Assignments Practice Location: 516 E Nizhoni Blvd, Gallup, NM 87301 Phone: 505-722-1000 | |
Dr. Catherine Marie Radovich, M.D. General Practice Medicare: Not Enrolled in Medicare Practice Location: 516 Nizhoni Blvd, Gallup Indian Medical Center, Gallup, NM 87301 Phone: 505-722-1000 | |
Dr. Michael Eric Ivory, DO General Practice Medicare: Not Enrolled in Medicare Practice Location: 516 E. Nizhoni Blvd., Gallup, NM 87301 Phone: 505-722-1000 Fax: 505-726-8740 | |
Dr. Jeffrey Joseph Hawker, M.D. General Practice Medicare: Accepting Medicare Assignments Practice Location: 516 E Nizhoni Blvd, Gallup, NM 87301 Phone: 505-722-1000 Fax: 540-224-1933 |