Individual
LAURO G. GUADERRAMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4401 MASTHEAD ST NE, SUITE 120, ALBUQUERQUE, NM 87109-4327
(505) 243-7729
(505) 243-4804
Mailing address
PO BOX 36840, ALBUQUERQUE, NM 87176-6840
(505) 243-7729
(505) 243-4804
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
87-242
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
14795
—
NM
Enumeration date
08/08/2006
Last updated
10/26/2011
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