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Individual

RICHARD H KRUIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
516 E. NIZHONI BLVD., GALLUP, NM 87301-1337
(505) 722-1000
(505) 722-1705
Mailing address
PO BOX 1337, GALLUP, NM 87305-1337
(505) 722-1000
(505) 722-1705

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
81246
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00006106
NM
05
415887
AZ
Enumeration date
06/22/2006
Last updated
05/09/2015
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