Healthcare Provider Details

I. General information

NPI: 1225444714
Provider Name (Legal Business Name): SALVADOR ADAME ZAMBRANO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2014
Last Update Date: 04/18/2025
Certification Date: 04/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 S DIAMOND AVE
DEMING NM
88030-3752
US

IV. Provider business mailing address

300 S DIAMOND AVE
DEMING NM
88030-3752
US

V. Phone/Fax

Practice location:
  • Phone: 575-546-4663
  • Fax: 575-546-4864
Mailing address:
  • Phone: 575-546-4663
  • Fax: 575-546-4844

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberRS2014-0581
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD2017-0814
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: