MEDICARE: JAMES RICHARD DELGADO MD

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	207Q00000X	Family Medicine Physician	99-36	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	NM009728	OTHER	NM	BCBS NM
2	PROVP12114	OTHER		MOLINA
3	2335621	OTHER		UHC
4	32464	OTHER		LOVELACE
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	201018320	OTHER		PRESBYTERIAN HEALTH PLANS
7	810852486	OTHER		PHCS

General Provider Information

NPI Number	:	1790753556
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES RICHARD DELGADO MD

Provider Business Mailing Address
First Line	:	5 PETROGLYPH CIR
Second Line	:	SUIGE A
City	:	SANTA FE
State	:	NM
Zip	:	87506-1001
Country	:	US
Telephone Number	:	505-455-1962
Fax Number	:	505-455-2355

Provider Business Practice Location Address
First Line	:	5 PETROGLYPH CIR
Second Line	:	SUIGE A
City	:	SANTA FE
State	:	NM
Zip	:	87506-1001
Country	:	US
Telephone Number	:	505-455-1962
Fax Number	:	505-455-2355

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

Provider Enumeration Date	:	03/09/2006
Last Update Date	:	03/11/2025

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Directions to “ JAMES RICHARD DELGADO MD” Practice Location

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