Individual
FERNANDO JAVIER PARDO-RUIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
122 S GOLD AVE, SUITE 3, DEMING, NM 88030-3755
(505) 544-7280
(505) 544-7281
Mailing address
122 S GOLD AVE, SUITE 3, DEMING, NM 88030-3755
(505) 544-7280
(505) 544-7281
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD2005-0179
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40273261
—
NM
01
—
A0008
TRICARE
—
01
—
NM009V80
BLUE CROSS BLUE SHIELD
NM
Enumeration date
08/18/2006
Last updated
09/26/2007
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