Evan Pulliam

Individual provider Active NPI Paramedic · Albuquerque, NM

NPI 1962882738 · NPPES record last updated Jun 5, 2015

Key facts

NPI
1962882738
Entity type
Individual (NPI type 1)
Primary specialty
Paramedic 146L00000X
Practice address
1515 Eubank Blvd SE BLDG 831832
Albuquerque, NM 87123-3453
Phone
(505) 412-1367
NPI assigned
Jun 5, 2015
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Paramedic 146L00000X Yes

Addresses

Primary practice location

1515 Eubank Blvd SE BLDG 831832
Albuquerque, NM 87123-3453

Mailing address

1515 Eubank Blvd SE BLDG 831832
Albuquerque, NM 87123-3453

Other providers in Albuquerque, NM

All providers in Albuquerque, NM · Paramedic in New Mexico

Sources for this page

Verify at the official NPI Registry.