Stuckwisch, Dawn

Stuckwisch, Dawn is an individual health care provider with primary practice located at 11601 Montgomery Blvd Ne , Albuquerque NM 87111-2660. She recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as her primary health care specialty. Stuckwisch, Dawn can be contacted via phone (505) 814-1995.

Contact Information

Primary practice address
11601 Montgomery Blvd Ne Albuquerque NM 87111-2660
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 01054092 Indiana
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X MD2020-1061 New Mexico

Profile Details

NPI number 1770593774
LBN Legal business name Stuckwisch, Dawn
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 9th, 2006
Last updated Dec 9th, 2020 - about 6 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 1770593774 NPPES
Indiana MEDICAID 200341050

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