Healthcare Provider Details

I. General information

NPI: 1033217211
Provider Name (Legal Business Name): RONALD P MONTEVERDE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 04/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 N TURNER ST SUITE 218
HOBBS NM
88240-6042
US

IV. Provider business mailing address

3 REGENCY SQ
HOBBS NM
88242-9789
US

V. Phone/Fax

Practice location:
  • Phone: 505-391-7572
  • Fax: 505-391-7576
Mailing address:
  • Phone: 575-602-1855
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number77-224
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number77-224
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: