Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | MD2007-0139 | NM |
Y | 207XS0106X | Orthopaedic Hand Surgeon | MD2007-0139 | NM |
NPI | 1124140413 |
---|---|
Provider Name | Donnie Edward Lujan |
First Address | Albuquerque, NM 87106 |
Second Address | Albuquerque, NM 87106 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2007 |
Last Update Date | 29/01/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
62777211 | (05) | NM |
MD2007-0139 | NEW MEXICO MEDICAL LICENS (01) | NM |