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Individual

STEPHEN VINGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
575 S ALAMEDA BLVD, LAS CRUCES, NM 88005
(575) 528-6400
(575) 521-7199
Mailing address
385 CALLE DE ALEGRA, BLDG. A, LAS CRUCES, NM 88005-3423
(575) 526-1105
(575) 524-4266

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
99-322
NM
2083X0100X
Occupational Medicine Physician
L3172
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00067812
NM
01
347642YRND
MEDICARE
NM
Enumeration date
04/03/2007
Last updated
06/11/2019
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