Individual
RITA JOSEPHINE DODGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2019 GALISTEO ST, SUITE N9A, SANTA FE, NM 87505
(505) 988-1930
(505) 982-9931
Mailing address
2019 GALISTEO ST, SUITE N9A, SANTA FE, NM 87505
(505) 988-1930
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20030007
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32405227
—
NM
Enumeration date
01/10/2007
Last updated
08/01/2011
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