Individual
MR. JOHN MATTHEW FAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3917 WEST ROAD, SUITE A MANNM, LOS ALAMOS, NM 87544
(505) 661-8900
(505) 661-8916
Mailing address
3917 WEST ROAD, SUITE A MANNM, LOS ALAMOS, NM 87544
(505) 661-8900
(505) 661-8916
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
DR44193
CO
207Q00000X
Family Medicine Physician
Primary
MD20060672
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
53123877
—
NM
Enumeration date
04/06/2006
Last updated
01/17/2012
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