Organization
BILA ASHDLA LLC
Active
Other names
Edward. J. Neidhardt MBR
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD JOSEPH NEIDHARDT M.D. (PSYCHIATRIST)
(505) 988-5667
Entity
Organization
Contact information
Practice address
103 S SAINT FRANCIS DR, SUITE C, SANTA FE, NM 87501-2458
(503) 988-5667
(505) 820-1632
Mailing address
3439 NE SANDY BLVD, PMB 375, PORTLAND, OR 97232-1959
(503) 593-9875
(503) 282-3302
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
89267
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41814
—
NM
Enumeration date
02/05/2007
Last updated
07/08/2013
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