Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 76-249 | NM |
N | 207XS0106X | Orthopaedic Hand Surgeon | 76-249 | NM |
NPI | 1104971886 |
---|---|
Provider Name | Herbert V Rachelson |
First Address | Albuquerque, NM 87125-6666 |
Second Address | Espanola, NM 87532 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2007 |
Last Update Date | 06/04/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
22384 | (05) | NM |
C98040 | (02) |