Alyssa Briana Mirabal, MD
Family Medicine in Edgewood, NM. Individual provider (NPI-1).
NPI number1043773005
StatusActive
Last updated in NPPESJul 27, 2023
Details
- NPI
- 1043773005
- Entity type
- Individual (NPI-1)
- Name
- Alyssa Briana Mirabal
- Credential
- MD
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Apr 8, 2019
- Certification date
- Jul 27, 2023
- Last updated
- Jul 27, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | MD2023-0130 | NM | Yes |
Practice location
1851 Old Us 66Edgewood, NM 87015-7200
Phone 505-286-2396 · Fax 505-272-8045
Mailing address
1851 Old Us 66Edgewood, NM 87015-7200
Phone 505-286-2396
Other practice locations
11501 Montgomery Blvd Ne
Albuquerque, NM 87111-2796
Albuquerque, NM 87111-2796
Phone 505-814-1333
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All 9 Family Medicine Physician providers in Edgewood · All 196 providers in Edgewood
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