Vanderslice, Duane E

Vanderslice, Duane E is an sole proprietor health care provider with primary practice located at 816 W Maple St , Farmington NM 87401-5631. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Vanderslice, Duane E can be contacted via phone (505) 327-3634.

Contact Information

Primary practice address
816 W Maple St Farmington NM 87401-5631
Fax: (505) 327-2104
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 83-134 New Mexico

Profile Details

NPI number 1407953177
LBN Legal business name Vanderslice, Duane E
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 17th, 2006
Last updated Nov 12th, 2008 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407953177 NPPES
New Mexico MEDICAID 22095
New Mexico Other 2836
New Mexico Other 850364974
New Mexico Other 201010266

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