Individual
JONATHAN SEVERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
104 CALLE LA PENA, SANTA FE, NM 87505-2877
(646) 280-6770
Mailing address
104 CALLE LA PENA, SANTA FE, NM 87505-2877
(646) 280-6770
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD2014-0018
NM
Other
Enumeration date
03/30/2011
Last updated
09/18/2017
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