Individual
RILEY NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
01 SAGEBRUSH, ISLETA, NM 87022
(505) 869-4863
(505) 869-4881
Mailing address
01 SAGEBRUSH, ISLETA, NM 87022-0000
(505) 869-4863
(505) 869-4881
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2003-0359
NM
Other
Enumeration date
10/03/2006
Last updated
08/02/2018
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