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NPI Code Detail

MEDICARE: ANDREW DAHL-BREDINE

MEDICARE:   ANDREW  DAHL-BREDINE
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
1104100000XSocial WorkerX-10217NM

General Provider Information

NPI Number : 1801303276
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW DAHL-BREDINE
Provider Business Mailing Address
First Line : 2329 COTTAGE SAN RD
Second Line :
City : SILVER CITY
State : NM
Zip : 88061-8988
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1311 N GRANT ST
Second Line :
City : SILVER CITY
State : NM
Zip : 88061-5134
Country : US
Telephone Number : 575-519-9232
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/06/2018
Last Update Date : 01/06/2018

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Directions to “ ANDREW DAHL-BREDINE ” Practice Location

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