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Individual

DR. RAPHAEL I SHAPIRO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1631 HOSPITAL DR, SUITE 240, SANTA FE, NM 87505-4728
(505) 913-3975
(505) 986-8001
Mailing address
1631 HOSPITAL DR, SUITE 240, SANTA FE, NM 87505-4728
(505) 913-3975
(505) 986-8001

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
80253
NM
208600000X
Surgery Physician
Primary
80253
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10088011
LOVELACE
05
12781
NM
01
202007840
PRESBYTERIAN HEALTH PLANS
01
38702
CCN
01
740201
UHC
01
NM012490
BCBS NM
NM
01
PROVP16424
MOLINA
Enumeration date
09/19/2005
Last updated
08/12/2010
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