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Individual

DR. LUIS RAUL RIVERA CRESPO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2801 E MISSOURI AVE, SUITE 7, LAS CRUCES, NM 88011-5061
(575) 521-8500
(575) 521-8400
Mailing address
525E LOHMAN AVE D, LAS CRUCES, NM 88001-3394
(575) 652-4426
(575) 652-4426

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
125053694
IL
207R00000X
Internal Medicine Physician
MD2011-1053
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
R16053678259
DRIVER LICENSE
IL
Enumeration date
12/18/2009
Last updated
10/14/2015
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