Individual
ARUP DAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2ND AMBULATORY CARE CTR, 2211 LOMAS BLVD. NE, ALBUQUERQUE, NM 87131-0001
(505) 272-2553
Mailing address
800 BRADBURY DR SE STE 116, ALBUQUERQUE, NM 87106-4310
(505) 272-1476
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
95-38
NM
Other
Enumeration date
07/24/2006
Last updated
02/06/2025
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