Idriss, Imad A.R.

Idriss, Imad A.R. is an individual health care provider with primary practice located at 2427 S Telshor Blvd , Las Cruces NM 88011-5049. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Idriss, Imad A.R. can be contacted via phone (575) 522-1059.

Contact Information

Primary practice address
2427 S Telshor Blvd Las Cruces NM 88011-5049
Fax: (575) 522-3652
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X 7841 New Mexico

Profile Details

NPI number 1134127947
LBN Legal business name Idriss, Imad A.R.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 14th, 2005
Last updated Oct 31st, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1134127947 NPPES
New Mexico MEDICAID 02782

Popular Providers