Organization
DAVID M. MACIAS, M.D., PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID M MACIAS M.D. (PRESIDENT)
(505) 984-8206
Entity
Organization
Contact information
Practice address
1925 ROSINA, SUITE D, SANTA FE, NM 87505-3355
(505) 984-8206
(505) 984-8274
Mailing address
1925 ROSINA, SUITE D, SANTA FE, NM 87505-3355
(505) 984-8206
(505) 984-8274
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
76-228
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Y0721
—
NM
Enumeration date
07/19/2007
Last updated
07/20/2007
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