MEDICARE: RICHARD SHAUN ARIES 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	207R00000X	Internal Medicine Physician	2004-0246	NM
2	207R00000X	Internal Medicine Physician	MD2006-0186	NM

General Provider Information

NPI Number	:	1932248937
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD SHAUN ARIES MD

Provider Business Mailing Address
First Line	:	2001 N. CENTRO FAMILIAR SW
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87105-4592
Country	:	US
Telephone Number	:	505-272-6338
Fax Number	:

Provider Business Practice Location Address
First Line	:	7704 A 2ND ST NW
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87107-6708
Country	:	US
Telephone Number	:	505-890-1458
Fax Number	:

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

Provider Enumeration Date	:	02/06/2007
Last Update Date	:	05/09/2012

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