Individual
M EILEEN MADRID
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
419 MANZANARES ST, LAS VEGAS, NM 87701-3882
(505) 425-6773
(505) 426-9238
Mailing address
419 MANZANARES ST, LAS VEGAS, NM 87701-3882
(505) 425-6773
(505) 426-9238
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
81-79
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00007088
—
NM
Enumeration date
03/24/2006
Last updated
04/08/2010
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