MEDICARE: R. STEVEN PADILLA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	78-234	NM

General Provider Information

NPI Number	:	1033126099
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	R. STEVEN PADILLA MD

Provider Business Mailing Address
First Line	:	933 BRADBURY DR SE
Second Line	:	SUITE 2222
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87106-4374
Country	:	US
Telephone Number	:	505-272-4947
Fax Number	:

Provider Business Practice Location Address
First Line	:	1021 MEDICAL ARTS AVE NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87102-2708
Country	:	US
Telephone Number	:	505-272-4947
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2006
Last Update Date	:	02/03/2012

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