Organization
DERMATOLOGY OF SANTA FE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELIZABETH A JESTER MD (OWNER)
(505) 986-9688
Entity
Organization
Contact information
Practice address
2019 GALISTEO ST, SUITE N-9B, SANTA FE, NM 87505-2143
(505) 986-9688
(505) 986-9090
Mailing address
2019 GALISTEO ST, SUITE N9B, SANTA FE, NM 87505-2143
(505) 986-9688
(505) 986-9090
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MD2004-0502
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1548260995
NPI
—
Enumeration date
03/15/2007
Last updated
08/22/2020
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