Healthcare Provider Details
I. General information
NPI: 1124086343
Provider Name (Legal Business Name): ROBERT BOND MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/04/2006
Last Update Date: 01/13/2025
Certification Date: 01/13/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3001 BROADMOOR BLVD NE
RIO RANCHO NM
87144-2100
US
IV. Provider business mailing address
800 BRADBURY DR SE STE 116
ALBUQUERQUE NM
87106-4310
US
V. Phone/Fax
- Phone: 505-994-7000
- Fax:
- Phone: 505-272-1476
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | MD2022-0068 |
| License Number State | NM |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | 01040532A |
| License Number State | IN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: