Individual
ROBERT M UNDERWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4820 E MAIN ST, FARMINGTON, NM 87402-8660
(505) 609-6495
(505) 324-0504
Mailing address
PO BOX 6210, FARMINGTON, NM 87499-6210
(505) 609-2258
(505) 609-2259
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0101230784
VA
207Q00000X
Family Medicine Physician
Primary
MD2018-0896
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1806441000
WEST VA MEDICAID
VA
05
—
5861896
—
VA
01
—
930116680
RAILROAD MEDICARE
VA
Enumeration date
06/12/2006
Last updated
05/29/2019
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