Provider First Line Business Practice Location Address: 
201 CEDAR ST SE STE 46304TH
    Provider Second Line Business Practice Location Address: 
PMG CEDAR ENDOCRINOLOGY
    Provider Business Practice Location Address City Name: 
ALBUQUERQUE
    Provider Business Practice Location Address State Name: 
NM
    Provider Business Practice Location Address Postal Code: 
87106-4917
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
505-563-6400
    Provider Business Practice Location Address Fax Number: 
505-563-6409
    Provider Enumeration Date: 
10/03/2006