Individual
FERNANDO LUGO
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Contact information
Practice address
255 HWY 187, HATCH, NM 87937-0370
(505) 267-3088
(505) 267-1747
Mailing address
PO BOX 370, HATCH, NM 87937-0370
(505) 267-3088
(505) 267-1747
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A1188-02
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01625527
—
NM
Enumeration date
08/24/2005
Last updated
07/08/2007
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