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Individual

SUZELLE L MOFFITT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
121 EL PASO RD, RUIDOSO, NM 88345-6033
(575) 630-8350
(575) 257-4055
Mailing address
575 HILL COUNTRY DR, STE 101, KERRVILLE, TX 78028-6024
(830) 258-7090
(830) 258-7098

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
H5566
TX
207Q00000X
Family Medicine Physician
Primary
MD2017-0489
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
21107831
NM
01
8GA072
BCBS PROVIDER ID NUMBER
TX
Enumeration date
04/11/2006
Last updated
07/21/2022
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