Gavin, Michael W

Gavin, Michael W is an individual health care provider with primary practice located at 1001 Dr Martin Luther King Jr Ave Ne , Albuquerque NM 87106-4713. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Gavin, Michael W can be contacted via phone (505) 272-4755.

Contact Information

Primary practice address
1001 Dr Martin Luther King Jr Ave Ne Albuquerque NM 87106-4713
Fax: (505) 272-6839
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X 93-60 New Mexico

Profile Details

NPI number 1255365391
LBN Legal business name Gavin, Michael W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 11th, 2006
Last updated Jun 7th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255365391 NPPES
New Mexico MEDICAID 4456

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