Nooreddeen Alsadi
Individual provider Active NPI Driver · Gallup, NM
NPI 1528698529 · NPPES record last updated Jan 19, 2020
Key facts
- NPI
- 1528698529
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- License
- 56624 (NM)
- Practice address
- 3850 E Highway 66
Gallup, NM 87301-4589 - Phone
- (480) 570-0745
- NPI assigned
- Jan 19, 2020
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 56624 | NM | MD | Driver |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Caring Carriage LLC | Current |
Accepting new patients |
Locations
2620 W Broadway Rd
Ste 12
Mesa, AZ 85202
Phone (480) 570-0745
3850 E Highway 66
Gallup, NM 87301
Phone (480) 570-0745
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | 56624 | NM | Yes |
Addresses
Primary practice location
3850 E Highway 66
Gallup, NM 87301-4589
Mailing address
2620 W Broadway Rd Ste 12
Mesa, AZ 85202-1071
Phone (480) 570-0745
Other providers in Gallup, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 19, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.