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Individual

DANIEL AGEE COLES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1700 CERRILLOS RD, SANTA FE, NM 87505-3554
(505) 988-9821
Mailing address
1625 WILDERNESS GATE RD, SANTA FE, NM 87505-5919
(505) 982-4420

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD2005-0503
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
67151337
NM
Enumeration date
01/17/2006
Last updated
09/13/2011
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