Individual
ROBERT ANTHONY GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2410 19TH ST SE, RIO RANCHO, NM 87124-4857
(505) 452-4200
(505) 452-4201
Mailing address
REGIONAL ADMIN OFFICE, 3411 N 5TH AVE., STE. 209, PHOENIX, AZ 85013-3812
(602) 789-0344
(602) 789-8389
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD2005-0514
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
329525
—
NM
Enumeration date
08/18/2005
Last updated
04/09/2018
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