NPI 1164435673 · live from the CMS NPI Registry
Aedra D. Andrade, MD
Family Medicine in Gallup, NM. National Provider Identifier 1164435673, active.
NPI record
| NPI | 1164435673 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Family Medicine 207Q00000X |
| Practice location | 610 N 5th St, Gallup, NM 87301 |
| Practice phone | 505-863-3120 |
| Mailing address | 1504 Fairway Cir, Gallup, NM 87301 |
| Enumerated | August 14, 2006 |
| Last updated | August 1, 2023 |
| Sole proprietor | No |
| Other names | Aedra Wenger |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Medicine primary | 207Q00000X | NM2003-0155 (NM) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.