Individual
DR. MARK EDWARD DWINELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
407 S SCHWARTZ AVE, SUITE 201, FARMINGTON, NM 87401-5925
(505) 609-6730
(505) 609-6749
Mailing address
PO BOX 6210, FARMINGTON, NM 87499-6210
(505) 609-2258
(505) 609-2259
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD2013-0979
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1049637-01
—
TX
05
—
104963701
—
TX
Enumeration date
06/28/2006
Last updated
04/28/2015
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