Healthcare Provider Details

I. General information

NPI: 1851438550
Provider Name (Legal Business Name): CRAIG RICHARD VROMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: CRAIG VROMAN MD

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 10/26/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5757 HARPER DR NE
ALBUQUERQUE NM
87109-3566
US

IV. Provider business mailing address

8801 HORIZON BLVD NE SUITE 360
ALBUQUERQUE NM
87113-1533
US

V. Phone/Fax

Practice location:
  • Phone: 505-888-5757
  • Fax: 505-875-0160
Mailing address:
  • Phone: 505-246-2622
  • Fax: 505-213-0103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD432251
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number25MA08284500
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD2009-0475
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: