OrganizationAlbuquerque Internal Medicine LlcInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address4121 Montgomery Blvd NE, Albuquerque, NM 87109-1102(505) 314-0748PECOS EnrollmentBased on the most recent information from CMS, provider Albuquerque Internal Medicine Llc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1023188679Provider TypeOrganizationFull NameAlbuquerque Internal Medicine LlcSubpartNoEnumeration Date11/9/2006Last Updated11/14/2012Contact InformationPractice LocationPractice Address4121 Montgomery Blvd NE, Albuquerque, NM 87109-1102Phone(505) 314-0748FaxUnlisted FaxMailing LocationMailing Address4101 Blue Ridge Pl NE, Albuquerque, NM 87111-4166Phone(505) 314-0748FaxUnlisted FaxAuthorized OfficialNameBerlin, William Oliver (Physician)Phone(505) 314-0748Provider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseUnlisted IssuerProvider IdentifiersIDDescriptionIssuerIDDD1175DescriptionOtherIssuerRAILROAD MEDICAREID00013372DescriptionMedicaidIssuerUnlistedNew MexicoIDNM019U17DescriptionOtherIssuerBLUE CROSS BLUE SHIELD