Individual
VIRGINIA G. CORPUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, FACP
Contact information
Practice address
4371 E LOHMAN AVE, LAS CRUCES, NM 88011
(575) 556-3241
(575) 526-6303
Mailing address
4371 E LOHMAN AVE, LAS CRUCES, NM 88011-8255
(575) 556-3241
(575) 526-6303
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
L0106
TX
207R00000X
Internal Medicine Physician
Primary
MD2007-0446
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1410490-03
—
TX
01
—
346726304
MEDICARE
NM
01
—
81605323
MEDICARE
NM
05
—
81605323
—
NM
Enumeration date
06/16/2005
Last updated
08/12/2019
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