Organization
MAURICE W. GELDERT OD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAURICE W GELDERT O.D. (PRESIDENT)
(575) 623-5111
Entity
Organization
Contact information
Practice address
200 W WILSHIRE BLVD, SUITE D, ROSWELL, NM 88201-0627
(575) 623-5111
(575) 623-9639
Mailing address
200 W WILSHIRE BLVD, SUITE D, ROSWELL, NM 88201-0627
(575) 623-5111
(575) 623-9639
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
383
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
P1483
—
NM
Enumeration date
02/03/2009
Last updated
03/30/2010
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