Individual
MARCUS LAWRENCE COULDRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
PO BOX 160, SHIPROCK, NM 87420-0160
(505) 368-6001
Mailing address
PO BOX 160, SHIPROCK, NM 87420-0160
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD2025-0605
NM
Other
Enumeration date
04/14/2022
Last updated
10/07/2025
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