Basic Information
| Provider Information | |||||||||
| NPI: | 1063621993 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TREME | ||||||||
| FirstName: | GEHRON | ||||||||
| MiddleName: | P | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 UNIVERSITY OF NEW MEXICO # 105600 | ||||||||
| Address2: | UNM HEALTH SCIENCES CENTER | ||||||||
| City: | ALBUQUERQUE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 871310001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5052724107 | ||||||||
| FaxNumber: | 5052728098 | ||||||||
| Practice Location | |||||||||
| Address1: | 2211 LOMAS BLVD NE | ||||||||
| Address2: | |||||||||
| City: | ALBUQUERQUE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 871062745 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5052724107 | ||||||||
| FaxNumber: | 5052728098 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/21/2007 | ||||||||
| LastUpdateDate: | 12/20/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | MD2009-0074 | NM | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | P00464726 | 01 | LA | RAILROAD MEDICARE INDIVIDUAL LEGACY NUMBER | OTHER | CI9478 | 01 | LA | RAILROAD MEDICARE GROUP LEGACY NUMBER | OTHER | 1033081 | 05 | LA | MEDICAID | CS00214348 | 01 | NM | CONTROLLED SUBSTANCE | OTHER | 4K785D847 | 01 | LA | MEDICARE LEGACY NUMBER | OTHER | FT0469684 | 01 | NM | DEA | OTHER | MD2009-0074 | 01 | NM | STATE LICENSE | OTHER | 201666 | 01 | LA | STATE LICENSE | OTHER |