Individual
MARK D LIVINGSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BA
Contact information
Practice address
2301 7TH ST STE A, LAS VEGAS, NM 87701-4966
(505) 454-9611
Mailing address
2301 7TH ST STE A, LAS VEGAS, NM 87701-4966
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
276
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
83774556
—
NM
Enumeration date
05/17/2019
Last updated
06/11/2019
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