Individual
MICHAEL RAY VANDUSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
801 W MAPLE ST, FARMINGTON, NM 87401
(505) 609-2000
(505) 609-2259
Mailing address
PO BOX 6210, FARMINGTON, NM 87499-6210
(505) 609-2258
(505) 609-2259
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
A-2141-18
NM
207L00000X
Anesthesiology Physician
N9004
TX
Other
Enumeration date
06/10/2009
Last updated
06/25/2018
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