Healthcare Provider Details

I. General information

NPI: 1194256784
Provider Name (Legal Business Name): CAMILO PAVEL WERLIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2017
Last Update Date: 11/07/2025
Certification Date: 11/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ROUTE 301 NORTH 21 B. AVENUE
ZUNI NM
87327
US

IV. Provider business mailing address

PO BOX 467
ZUNI NM
87327-0467
US

V. Phone/Fax

Practice location:
  • Phone: 505-782-4431
  • Fax: 505-782-7406
Mailing address:
  • Phone: 505-782-4431
  • Fax: 505-782-7406

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD2019-0905
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: