Individual
DANIEL E RAES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 W COUNTRY CLUB RD, SUITE# 220, ROSWELL, NM 88201-5202
(505) 625-1292
Mailing address
405 W COUNTRY CLUB RD, C/O MSO ADMINISTRATION, ROSWELL, NM 88201-5209
(575) 624-4777
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
94-126
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30722
—
NM
01
—
NPI#
BCBS OF NM
NM
Enumeration date
09/29/2005
Last updated
02/09/2011
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