Healthcare Provider Details

I. General information

NPI: 1700115615
Provider Name (Legal Business Name): ERIKA M OVIEDO D.O.M
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/24/2009
Last Update Date: 12/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303C COUNTY ROAD 59
VELARDE NM
87582
US

IV. Provider business mailing address

PO BOX 1261
ALCALDE NM
87511-1261
US

V. Phone/Fax

Practice location:
  • Phone: 505-927-5225
  • Fax:
Mailing address:
  • Phone: 505-927-5225
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number991
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: