Individual
CHARLES J.S. GUIMARAES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1900 RED ROCK DR., REHOBOTH MCKINLEY CHRISTIAN HEALTH CARE SERVICES, GALLUP, NM 87301
(505) 863-7200
Mailing address
1901 REDROCK DR, PFS DEPT, GALLUP, NM 87301-5683
(505) 863-7000
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
99-116
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10002629
LOVELACE HEALTH/SALUD
NM
05
—
465668
—
AZ
05
—
84984872
—
NM
01
—
85031326887301A023
CHAMPUS
—
01
—
NM004683
BC/BS
NM
01
—
PROVP12644
MOLINA
NM
Enumeration date
01/09/2006
Last updated
07/08/2007
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