Basic Information
| Provider Information | |||||||||
| NPI: | 1598770059 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SIBBITT | ||||||||
| FirstName: | WILMER | ||||||||
| MiddleName: | L | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2211 LOMAS BLVD NE FL 5 | ||||||||
| Address2: | MSC10 5550 | ||||||||
| City: | ALBUQUERQUE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 871062745 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5052724761 | ||||||||
| FaxNumber: | 5052723824 | ||||||||
| Practice Location | |||||||||
| Address1: | 2211 LOMAS BLVD NE FL 5 | ||||||||
| Address2: | MSC10 5550 | ||||||||
| City: | ALBUQUERQUE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 871062745 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5052724761 | ||||||||
| FaxNumber: | 5052723824 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/30/2006 | ||||||||
| LastUpdateDate: | 04/27/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RR0500X | 81-124 | NM | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology |
No ID Information.