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Individual

CALVIN DUDLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3810 MASTHEAD ST NE, ALBUQUERQUE, NM 87109-4479
(505) 243-3514
(505) 243-3451
Mailing address
3810 MASTHEAD ST NE, ALBUQUERQUE, NM 87109-4479
(505) 243-3514
(505) 243-3451

Taxonomy

Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
86-222
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
201002646
PRESBYTERIAN HEALTH PLAN
NM
05
37689
NM
01
NM010744
BCBS NEW MEXICO
NM
Enumeration date
07/21/2006
Last updated
02/09/2009
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