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NPI Code Detail

MEDICARE: WILLIAM EDWARD BRANCO

MEDICARE:   WILLIAM EDWARD BRANCO
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
1175T00000XPeer Specialist

General Provider Information

NPI Number : 1114562360
Entity Type Code : Individual
Provider Name (Legal Business Name) : WILLIAM EDWARD BRANCO
Provider Business Mailing Address
First Line : 303 N ALAMEDA BLVD
Second Line :
City : LAS CRUCES
State : NM
Zip : 88005-2590
Country : US
Telephone Number : 575-523-0111
Fax Number :
Provider Business Practice Location Address
First Line : 303 N ALAMEDA BLVD
Second Line :
City : LAS CRUCES
State : NM
Zip : 88005-2590
Country : US
Telephone Number : 575-523-0111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/12/2019
Last Update Date : 11/12/2019

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Directions to “ WILLIAM EDWARD BRANCO ” Practice Location

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