Provider Demographics
NPI:1700924560
Name:HURSH, MARGARET DIANE (DOM)
Entity type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:DIANE
Last Name:HURSH
Suffix:
Gender:F
Credentials:DOM
Other - Prefix:DR
Other - First Name:MARGARET
Other - Middle Name:DIANE
Other - Last Name:HURSH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DOM
Mailing Address - Street 1:6017 HANNETT AVE NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-5914
Mailing Address - Country:US
Mailing Address - Phone:505-244-8401
Mailing Address - Fax:
Practice Address - Street 1:6017 HANNETT AVE NE
Practice Address - Street 2:817 ARNO SE
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-5914
Practice Address - Country:US
Practice Address - Phone:505-244-8401
Practice Address - Fax:505-243-1473
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM715171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist