MEDICARE: MR. JUAN JOSE SILVA CAMPOS M.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	MD2026-0088	NM

General Provider Information

NPI Number	:	1437771300
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JUAN JOSE SILVA CAMPOS M.D

Provider Business Mailing Address
First Line	:	PO BOX 26666
Second Line	:	PHS PROVIDER ENROLLMENT
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87125-6666
Country	:	US
Telephone Number	:	505-841-1995
Fax Number	:	505-841-1373

Provider Business Practice Location Address
First Line	:	1100 CENTRAL AVE SE S2 TOWER F
Second Line	:	PATHOLOGY
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87106-4930
Country	:	US
Telephone Number	:	505-841-1995
Fax Number	:	505-841-1373

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/13/2020
Last Update Date	:	06/02/2026

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