Individual
ROGER WESLEY GILDERSLEEVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12127B HWY 14 N STE 5, CEDAR CREST, NM 87008-9499
(505) 281-5180
(505) 281-5320
Mailing address
12127B HWY 14 N STE 5, CEDAR CREST, NM 87008-9499
(505) 281-5180
(505) 281-5320
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
M6632
TX
207Q00000X
Family Medicine Physician
Primary
MD2004-0789
NM
Other
Enumeration date
02/01/2006
Last updated
12/08/2015
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