Individual
EVANGEL MALDONADO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1200 HIGHWAY 60, SOCORRO, NM 87801-3914
(575) 835-2424
(575) 838-0150
Mailing address
1200 HIGHWAY 60, SOCORRO, NM 87801-3914
(575) 835-2424
(575) 838-0150
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/21/2017
Last updated
04/21/2017
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