Individual
MR. RUSSELL RODOLFO DE PALMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CP
Contact information
Practice address
1010 LEAD AVE SE STE 400, ALBUQUERQUE, NM 87106-5214
(505) 247-0430
(505) 820-2392
Mailing address
1691 GALISTEO ST STE B, SANTA FE, NM 87505-4781
(505) 820-2390
(505) 820-2392
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CP003517
AMERICAN BOARD FOR CERTIFICATION
VA
Enumeration date
04/23/2021
Last updated
04/23/2021
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