Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 1685 | NM |
NPI | 1801921697 |
---|---|
Provider Name | Dr. Robert C Garey |
First Address | Las Cruces, NM 88011-8245 |
Second Address | Las Cruces, NM 88011-8245 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U11114 | (02) |