Individual
DUSTIN C STAPLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
4901 LANG AVE NE, ALBUQUERQUE, NM 87109-4397
(505) 842-8171
(505) 246-0684
Mailing address
4901 LANG AVE NE, ALBUQUERQUE, NM 87109-4397
(505) 842-8171
(505) 246-0684
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
007962
GA
363A00000X
Physician Assistant
Primary
PA2022-0077
NM
Other
Enumeration date
01/11/2017
Last updated
08/12/2024
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