Healthcare Provider Details

I. General information

NPI: 1740377886
Provider Name (Legal Business Name): DAVID BRIAN ARCINIEGAS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2006
Last Update Date: 10/05/2020
Certification Date: 10/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 UNIVERSITY OF NEW MEXICO MSC09 5030
ALBUQUERQUE NM
87131
US

IV. Provider business mailing address

1 UNIVERSITY OF NEW MEXICO MSC09 5030
ALBUQUERQUE NM
87131
US

V. Phone/Fax

Practice location:
  • Phone: 303-907-0878
  • Fax:
Mailing address:
  • Phone: 303-907-0878
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License Number34652
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License NumberP4541
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License NumberMD2020-0884
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: