Individual
DR. MELQUIADES OLIVARES JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D,
Contact information
Practice address
260 MILLS AVE, LAS VEGAS, NM 87701-4125
(505) 425-6731
(505) 454-9193
Mailing address
260 MILLS AVE, LAS VEGAS, NM 87701-4125
(505) 425-6731
(505) 454-9193
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
90265
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00042138
—
NM
Enumeration date
08/01/2006
Last updated
06/18/2010
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