Healthcare Provider Details

I. General information

NPI: 1700872470
Provider Name (Legal Business Name): CHRISTOPHER A ROVETO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4233 MONTGOMERY NE STE 120
ALBUQUERQUE NM
87109
US

IV. Provider business mailing address

4233 MONTGOMERY NE STE 120
ALBUQUERQUE NM
87109
US

V. Phone/Fax

Practice location:
  • Phone: 505-247-1471
  • Fax: 505-214-5020
Mailing address:
  • Phone: 505-247-1471
  • Fax: 505-214-5020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number86118
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: