| Doctor Name: | JEREMY WERDERMAN |
| NPI Number: | 1144627274 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 1181 Capitan St Nw Los Lunas, NM - 870316909 |
| Business Phone Number: | 5059160355 |
| Business Fax Number: | |
| Mailing Address: | 1181 Capitan St Nw, LOS LUNAS |
| State: | NM |
| Postal Code: | 870316909 |
| Phone Number: | 5059160355 |
| Fax Number: | |
| NPI Enumeration Date: | 12/04/2014 |
| NPI Last Update Date: | 12/04/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 247000000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
| Taxonomy Classification: | Technician, Health Information |
| Taxonomy Specialization: | |
| Taxonomy Definition: | Preferred term for an Accredited Record Technician who is an individual with an associate |