Individual
AIDEN MATTHEW O'ROURKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1399 WEIMER RD, # 600, TAOS, NM 87571-6340
(575) 751-0334
(575) 751-0297
Mailing address
1399 WEIMER RD, # 600, TAOS, NM 87571-6340
(575) 751-0334
(575) 751-0297
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD2013-0822
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
67251382
—
NM
Enumeration date
04/05/2006
Last updated
09/13/2017
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