Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 170100000X | Medical Geneticist |
NPI | 1669041737 |
---|---|
Provider Name | Dr. Sheldon Jordan |
First Address | Albuquerque, NM 87110-5200 |
Second Address | Albuquerque, NM 87110-5200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2021 |
Last Update Date | 22/06/2021 |