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NPI Code Detail

MEDICARE: RICHARD SAUL DIAZ TUSHMAN MD

MEDICARE:   RICHARD SAUL DIAZ TUSHMAN  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
1208800000XUrology Physician35967AZ
2208800000XUrology PhysicianMD2006-0523NM
3208800000XUrology PhysicianMD.200955LA

Other Identifiers

General Provider Information

NPI Number : 1568493773
Entity Type Code : Individual
Provider Name (Legal Business Name) : RICHARD SAUL DIAZ TUSHMAN MD
Provider Business Mailing Address
First Line : 2410 W PIERCE ST
Second Line :
City : CARLSBAD
State : NM
Zip : 88220-3512
Country : US
Telephone Number : 575-887-7281
Fax Number : 575-885-5983
Provider Business Practice Location Address
First Line : 2410 W PIERCE ST
Second Line :
City : CARLSBAD
State : NM
Zip : 88220-3512
Country : US
Telephone Number : 575-887-7281
Fax Number : 575-885-5983
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2006
Last Update Date : 12/15/2021

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Directions to “ RICHARD SAUL DIAZ TUSHMAN MD” Practice Location

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