Basic Information
Provider Information
NPI: 1457714552
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PRICE
FirstName: AMBER
MiddleName: L
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: HARLAN
OtherFirstName: AMBER
OtherMiddleName: L
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: MD
OtherLastNameType: 1
Mailing Information
Address1: MSC 10 5600 1 UNIVERSITY OF NEW MEXICO
Address2:  
City: ALBUQUERQUE
State: NM
PostalCode: 871310001
CountryCode: US
TelephoneNumber: 5052724107
FaxNumber: 5052728098
Practice Location
Address1: MSC 10 5600 1 UNIVERSITY OF NEW MEXICO
Address2:  
City: ALBUQUERQUE
State: NM
PostalCode: 871310001
CountryCode: US
TelephoneNumber: 5052724107
FaxNumber: 5052728098
Other Information
ProviderEnumerationDate: 04/05/2016
LastUpdateDate: 11/16/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/16/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207X00000XMD2021-0777NMY Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 

No ID Information.


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