| Uptown Dermatology LLC | |
|
8016 Constitution Pl Ne Albuquerque NM 87110-7628 | |
| (505) 508-4309 | |
| (505) 835-5687 |
| Full Name | Uptown Dermatology LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 8016 Constitution Pl Ne, Albuquerque, New Mexico |
| Authorized Official Name and Position | Ran H Bang (PRESIDENT) |
| Authorized Official Contact | 5055084309 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Uptown Dermatology LLC 8016 Constitution Pl Ne Albuquerque NM 87110-7628 Ph: (505) 508-4309 | Uptown Dermatology LLC 8016 Constitution Pl Ne Albuquerque NM 87110-7628 Ph: (505) 508-4309 |
| NPI Number | 1285260588 |
|---|---|
| Provider Enumeration Date | 03/18/2020 |
| Last Update Date | 03/18/2020 |
| Certification Date | 03/18/2020 |
| Medicare PECOS PAC ID | 4385082759 |
|---|---|
| Medicare Enrollment ID | O20240404000187 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285260588 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Primary |
| Provider Name | Ran H Bang |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1194731893 PECOS PAC ID: 7416049341 Enrollment ID: I20070823000621 |
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