Healthcare Provider Details

I. General information

NPI: 1952339681
Provider Name (Legal Business Name): RODERICK FIELDS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 07/17/2025
Certification Date: 07/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2211 LOMAS, NE 5TH FLOOR-5ACC
ALBUQUERQUE NM
87106-0001
US

IV. Provider business mailing address

800 BRADBURY DR SE STE 116
ALBUQUERQUE NM
87106-4310
US

V. Phone/Fax

Practice location:
  • Phone: 505-272-3840
  • Fax: 505-272-4367
Mailing address:
  • Phone: 505-272-1476
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number76169
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: