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Individual

CALVIN A RIDGEWAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4701 MONTGOMERY BLVD NE, BREAST CARE CENTER, ALBUQUERQUE, NM 87109-1219
(505) 727-6900
(505) 727-6913
Mailing address
4701 MONTGOMERY BLVD NE, BREAST CARE CENTER, ALBUQUERQUE, NM 87109-1219

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
94373
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
56476
NM
Enumeration date
10/03/2006
Last updated
07/17/2015
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