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General NPI Number Information
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NPI Number | 1245419811
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Entity Type | Organization
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Legal Business Name | MICHAEL S MISHKIN MD PC
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Dates
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Enumeration Date | 10/30/2007
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Last Update Date | 02/29/2008
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Provider Practice Location Address
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Address Line | 1315 12TH ST
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City | ALAMOGORDO
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State | NM
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Zip | 88310-5810
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Country | US
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Telephone | 575-437-5716
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Fax |
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Provider Business Mailing Address
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Address Line | 1315 12TH ST
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City | ALAMOGORDO
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State | NM
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Zip | 88310-5810
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Country | US
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Telephone | 575-437-5716
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL STEPHEN MISHKIN
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Credential | MD
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Telephone | 575-437-5716
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 93337
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License Number State | NM
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