Individual
CAESAR MARCELO URSIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1631 HOSPITAL DR, SUITE 240, SANTA FE, NM 87505-4728
(505) 954-8728
Mailing address
455 SAINT MICHAELS DR, MEDICAL STAFF OFFICE, SANTA FE, NM 87505-7601
(505) 820-5227
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD2005-0735
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10024240
LOVELACE
—
01
—
202004080
PRESBYTERIAN HEALTH PLANS
—
01
—
2587220
UHC
—
05
—
32428766
—
NM
01
—
742912
CCN
—
01
—
NM009X45
BCBS NM
NM
01
—
QMYPR0071514
MOLINA
—
Enumeration date
03/09/2006
Last updated
12/12/2007
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