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NPI Code Detail

MEDICARE: DR. MARK CAVARETTA MD

MEDICARE: DR. MARK CAVARETTA 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
1208600000XSurgery PhysicianMD2024-0085NM

General Provider Information

NPI Number : 1942400643
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARK CAVARETTA MD
Provider Business Mailing Address
First Line : 251 N ROADRUNNER PKWY APT 203
Second Line :
City : LAS CRUCES
State : NM
Zip : 88011-8097
Country : US
Telephone Number : 716-440-9669
Fax Number :
Provider Business Practice Location Address
First Line : 4351 E LOHMAN AVE STE 320
Second Line :
City : LAS CRUCES
State : NM
Zip : 88011-8262
Country : US
Telephone Number : 575-522-4940
Fax Number : 575-522-4932
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2007
Last Update Date : 02/15/2024

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Directions to “ DR. MARK CAVARETTA MD” Practice Location

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