Individual
EDWARD ROBLES MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
516 E. NIZHONI BLVD, GALLUP, NM 87301-1337
(505) 722-1000
(505) 722-1421
Mailing address
PO BOX 1337, GALLUP, NM 87305-1337
(505) 722-1000
(505) 722-1421
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
227427
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01221787
—
NM
05
—
759128
—
AZ
Enumeration date
06/14/2006
Last updated
04/11/2008
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