Individual
BASIL A ANAELE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1521 W 13TH ST, CLOVIS, NM 88101-5568
(575) 769-0888
(575) 763-9154
Mailing address
1515 W FIR ST, PORTALES, NM 88130-5703
(575) 356-6695
(575) 356-5948
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD2012-0726
NM
Other
Enumeration date
11/06/2012
Last updated
11/06/2012
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