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Individual

JAN V.T. BEAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1631 HOSPITAL DR, SUITE 200, SANTA FE, NM 87505-4766
(505) 424-0200
(505) 424-6608
Mailing address
1631 HOSPITAL DR, SUITE 200, SANTA FE, NM 87505-4766
(505) 424-0200
(505) 424-6608

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
88-5
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10004689
LOVELACE
01
356703
PHCS
05
82226385
NM
01
884647
UHC
01
98066
CCN
01
NM001H10
BCBS NM
NM
01
PROVP11527
MOLINA
Enumeration date
05/27/2006
Last updated
10/31/2007
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