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Individual

ALI M GHAFFARI SR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
815 WEST 14TH ST, CLOVIS, NM 88101
(505) 762-6492
(505) 762-9981
Mailing address
815 W 14TH ST, CLOVIS, NM 88101-5514
(505) 762-6492
(505) 762-9981

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
81202
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
S2511
NM
Enumeration date
05/18/2006
Last updated
08/30/2010
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