Healthcare Provider Details

I. General information

NPI: 1689713612
Provider Name (Legal Business Name): NATHAN GOLDFEIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2669 SCENIC DR
ALAMOGORDO NM
88310-8700
US

IV. Provider business mailing address

101 MCGINNIS RD
TIJERAS NM
87059-7938
US

V. Phone/Fax

Practice location:
  • Phone: 575-439-6900
  • Fax:
Mailing address:
  • Phone: 505-553-4806
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2005-0462
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: