Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | G80896 | CA |
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | MD2011-0725 | NM |
NPI | 1487624961 |
---|---|
Provider Name | Dr. Mark E Werner |
First Address | Albuquerque, NM 87109-5900 |
Second Address | Albuquerque, NM 87109-5900 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2006 |
Last Update Date | 08/11/2012 |