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Individual

DR. MICHAEL J. VENDRELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4411 THE 25 WAY NE, #150, ALBUQUERQUE, NM 87109-5857
(651) 245-3950
(413) 643-4773
Mailing address
4220 HERSCHEL AVE, APT 809, DALLAS, TX 75219-2380
(651) 245-3950

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
44127
MN
2085R0202X
Diagnostic Radiology Physician
Primary
80-278
NM
2085R0202X
Diagnostic Radiology Physician
MD00047308
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
662665300
MN
Enumeration date
12/22/2005
Last updated
03/31/2017
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