Individual
FIDELIS ONOH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1604 E SPRUCE ST, PORTALES, NM 88130-9489
(575) 359-3420
Mailing address
840 MOLTEN PL NW, ALBUQUERQUE, NM 87120-1742
(505) 559-3940
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP00009245
NM
Other
Enumeration date
02/26/2020
Last updated
02/26/2020
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