Individual
DR. NATHANIEL WEST REDISKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 UNIVERSITY OF NEW MEXICO, MSC11 6093, ALBUQUERQUE, NM 87131-0001
(505) 272-6225
(505) 272-5184
Mailing address
1509 VISTA LARGA CT NE, ALBUQUERQUE, NM 87106-2646
(414) 403-6635
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
52586
MT
2084P0805X
Geriatric Psychiatry Physician
Primary
MD2015-0602
NM
Other
Enumeration date
06/29/2010
Last updated
03/17/2018
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