Doctor Name: | DR. TIERAONA LOW DOG |
NPI Number: | 1457583049 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | 98-321 |
Business Practice Address: | 3600 Cerrillos Rd Suite 712 Santa Fe, NM - 875072612 |
Business Phone Number: | 5054240613 |
Business Fax Number: | |
Mailing Address: | 3600 Cerrillos Rd, Suite 712 SANTA FE |
State: | NM |
Postal Code: | 875072612 |
Phone Number: | 5054240613 |
Fax Number: | |
NPI Enumeration Date: | 08/14/2009 |
NPI Last Update Date: | 08/14/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 98-321 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |