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Individual

DR. EDGAR JANETZKO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1960 N DATE ST, TRUTH OR CONSEQUENCES, NM 87901-3701
(575) 894-7662
(575) 894-7930
Mailing address
PO BOX 370, HATCH, NM 87937-0370
(575) 267-3280
(575) 267-1747

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
96-286
NM
207R00000X
Internal Medicine Physician
L1895
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1447278-01
TX
Enumeration date
04/06/2006
Last updated
08/31/2022
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