Individual
DANIEL XETHAN HAIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
500 N MUNDO, DULCE, NM 87528-0187
(575) 759-3291
(575) 759-3651
Mailing address
PO BOX 187, DULCE, NM 87528-0187
(575) 759-3291
(575) 759-3651
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2019044493
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/10/2017
Last updated
07/21/2020
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