Edgewood Pediatric Clinic L.l.c.

NPI #1699905927 in Edgewood, New Mexico

Provider Information

NPI Number: 1699905927
Entity Type: Organization
Organization Name: Edgewood Pediatric Clinic L.l.c.
Primary Specialty: Pediatrics
Enumeration Date: Jul 21, 2009
Last Updated: May 30, 2012

Practice Location

Address: 2 EUNICE CT BLDG B
City: Edgewood
State: New Mexico
ZIP Code: 87015-9108
Phone: (505) 281-4620

Authorized Official

Name: DR. SHARON DIANE GARNAND, MD
Title: OWNER
Phone: (505) 281-4620

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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