Basic Information
| Provider Information | |||||||||
| NPI: | 1841365731 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PRESS | ||||||||
| FirstName: | RONALD | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 435 ST MICHAELS DR | ||||||||
| Address2: | STE B104 | ||||||||
| City: | SANTA FE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 875057671 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5059923334 | ||||||||
| FaxNumber: | 5059921998 | ||||||||
| Practice Location | |||||||||
| Address1: | 435 ST MICHAELS DR | ||||||||
| Address2: | STE B104 | ||||||||
| City: | SANTA FE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 875057671 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5059923334 | ||||||||
| FaxNumber: | 5059921998 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/24/2006 | ||||||||
| LastUpdateDate: | 02/01/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 87322 | NM | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 73734373 | 05 | NM | MEDICAID |