Individual
DR. ALFREDO NEVAREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1016 E ROOSEVELT AVE, GRANTS, NM 87020-2118
(505) 287-4446
(505) 287-5343
Mailing address
1016 E ROOSEVELT AVE, GRANTS, NM 87020-2118
(505) 287-4446
(505) 287-5343
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
58019
AZ
207Q00000X
Family Medicine Physician
Primary
MD2019-0669
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30678501
—
NM
01
—
MD2019-0669
NM LICENSE
NM
Enumeration date
06/16/2016
Last updated
08/16/2021
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