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Individual

CHARLES MARK RACE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2539 MEDICAL DR, STE 110, ALAMOGORDO, NM 88310-8720
(575) 434-2116
(575) 434-2051
Mailing address
2669 SCENIC DR, ALAMOGORDO, NM 88310-8700
(515) 955-6767

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD2009-0724
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0425561
IA
01
1175
MIDLANDS
IA
01
35351
WELLMARK
IA
01
36167
WELLMARK
IA
05
9098947
IA
01
DC9737
RR MEDICARE
IA
01
F244880
MIDLANDS
IA
01
P00041350
RR MEDICARE
IA
Enumeration date
05/23/2006
Last updated
01/11/2017
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