Individual
DR. NICOLA L CHIARADONNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2525 S TELSHOR BLVD, LAS CRUCES, NM 88011-5071
(505) 522-6236
(505) 522-2157
Mailing address
3480 PRESTON RIDGE RD STE 600, CREDENTIALING DEPT, ALPHARETTA, GA 30005-5462
(770) 300-0101
(770) 300-0429
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
2006002442
MO
2085R0202X
Diagnostic Radiology Physician
32308
AZ
2085R0202X
Diagnostic Radiology Physician
Primary
MD2006-0702
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
83801
AR BLUE SHIELD #
AR
Enumeration date
11/08/2006
Last updated
07/19/2007
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