Individual
RANDALL NEDERHOFF
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Contact information
Practice address
2400 UNSER BLVD SE, RIO RANCHO, NM 87124-4740
(505) 253-2100
(850) 253-2121
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
88-232
NM
Other
Enumeration date
04/05/2006
Last updated
11/02/2017
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