Individual
RONALD BLISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2300 E 30TH ST, BLDG B, STE 102, FARMINGTON, NM 87401-8990
(505) 324-1000
(505) 324-1199
Mailing address
2300 E 30TH ST, BLDG B, STE 102, FARMINGTON, NM 87401-8990
(505) 324-1000
(505) 324-1199
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2000-145
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20592
LOVELACE
NM
01
—
57647
PRESBYTERIAN SALUD
NJ
05
—
62965
—
NM
01
—
80156045
RAILROAD RETIREMENT
—
01
—
NM004266
BLUE CROSS
NM
Enumeration date
01/09/2006
Last updated
01/22/2008
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