| Evolveabq Professional Corporation | |
|
4550 Eubank Blvd Ne Ste 108 Albuquerque NM 87111-2565 | |
| (505) 616-0915 | |
| Not Available |
| Full Name | Evolveabq Professional Corporation |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 4550 Eubank Blvd Ne Ste 108, Albuquerque, New Mexico |
| Authorized Official Name and Position | Lida Fatemi (PRACTITIONER) |
| Authorized Official Contact | 5052723120 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evolveabq Professional Corporation 4550 Eubank Blvd Ne Ste 108 Albuquerque NM 87111-2565 Ph: () - | Evolveabq Professional Corporation 4550 Eubank Blvd Ne Ste 108 Albuquerque NM 87111-2565 Ph: (505) 616-0915 |
| NPI Number | 1952293466 |
|---|---|
| Provider Enumeration Date | 07/18/2025 |
| Last Update Date | 07/18/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952293466 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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