Individual
DENNIS MADRID
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
15 JUNIPER PL, LOS LUNAS, NM 87031-5781
(760) 585-6632
Mailing address
15 JUNIPER PL, LOS LUNAS, NM 87031-5781
(760) 585-6632
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
85-237
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
W2687
—
NM
Enumeration date
02/07/2012
Last updated
02/07/2012
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