Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 2018024913 | MO |
N | 111NI0900X | Internist | 2018024913 | MO |
N | 207R00000X | Internist | 34009639 | OH |
N | 111NI0900X | Internist | 34009639 | OH |
N | 207R00000X | Internist | Q2950 | TX |
N | 111NI0900X | Internist | Q2950 | TX |
Y | 207RR0500X | Rheumatology | A242620 | NM |
NPI | 1093725681 |
---|---|
Provider Name | Silver Cree Sisneros |
First Address | Santa Fe, NM 87505-1102 |
Second Address | Santa Fe, NM 87505-1102 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2006 |
Last Update Date | 10/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
020A70391 | (05) | CA |
2992847 | (05) | OH |
58527226 | (02) | |
9810016081 | (05) | WV |