NPI Profile for NORTHERN NEW MEXICOORTHOPAEDIC CENTERPC in ESPAÑOLA, NM.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Surgical |
363AS0400X | 97 | Physician Assistant | |
Medical |
363AM0700X | 97 | Physician Assistant | |
Specialist |
174400000X | |||
Surgery, Foot & Ankle |
213ES0103X | 48 | Podiatry |
| NPI # | 1043329139 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 08/30/2006 | |
| Last updated | 09/11/2025 - About 9 months ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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NORTHERN NEW MEXICOORTHOPAEDIC CENTER,PC
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