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Organization

DUANE E VANDERSLICE, M.D., F.A.C.O.G., P.C.

Active
Other names
WOMEN'S CLINIC
Organization subpart
No

Provider details

NPI number
Authorized official
DUANE E VANDERSLICE M.D. (PRESIDENT)
(505) 327-3634
Entity
Organization

Contact information

Practice address
816 W MAPLE ST, FARMINGTON, NM 87401-5631
(505) 327-3634
(505) 327-2104
Mailing address
816 W MAPLE ST, FARMINGTON, NM 87401-5631
(505) 327-3634
(505) 327-2104

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
83-134
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
201010266
PRESBYTERIAN HEALTH/SALUD
NM
05
22095
NM
01
2836
BLUE CROSS BLUE SHIELD
NM
Enumeration date
11/21/2008
Last updated
11/21/2008
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