Individual
DR. MIA KRISTEN LOZADA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
516 E. NIZHONI BLVD., GALLUP, NM 87301-1337
(505) 722-1000
(505) 726-8557
Mailing address
P.O. BOX 1337, GALLUP, NM 87305-1337
(505) 722-1000
(505) 726-8557
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A111814
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
730176
—
AZ
05
—
83952314
—
NM
Enumeration date
05/28/2009
Last updated
03/19/2015
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