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Individual

DR. DAVID M MACIAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1925 ROSINA ST, SUITE D, SANTA FE, NM 87505-3357
(505) 984-8206
(505) 984-8274
Mailing address
1925 ROSINA ST, SUITE D, SANTA FE, NM 87505-3357
(505) 984-8206
(505) 984-8274

Taxonomy

Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
76-228
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
Y0721
NM
Enumeration date
12/09/2005
Last updated
07/17/2007
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