Individual
ROBERTO AGUERO BLAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1007 N POPE ST, SILVER CITY, NM 88061-5161
(575) 388-1511
Mailing address
1007 N POPE ST, SILVER CITY, NM 88061-5161
(888) 368-6983
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD2019-1096
NM
207Q00000X
Family Medicine Physician
RS2015-0330
NM
208D00000X
General Practice Physician
MD2019-1096
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD2019-1096
NM MEDICAL BOARD
NM
Enumeration date
04/07/2015
Last updated
08/11/2020
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