Provider Demographics
NPI:1801058706
Name:RONALD P MONTEVERDE MD PC
Entity type:Organization
Organization Name:RONALD P MONTEVERDE MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:P
Authorized Official - Last Name:MONTEVERDE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:575-391-7572
Mailing Address - Street 1:1601 N TURNER ST
Mailing Address - Street 2:SUITE 218
Mailing Address - City:HOBBS
Mailing Address - State:NM
Mailing Address - Zip Code:88240-4331
Mailing Address - Country:US
Mailing Address - Phone:575-391-7572
Mailing Address - Fax:575-391-7576
Practice Address - Street 1:1601 N TURNER ST
Practice Address - Street 2:SUITE 218
Practice Address - City:HOBBS
Practice Address - State:NM
Practice Address - Zip Code:88240-4331
Practice Address - Country:US
Practice Address - Phone:575-391-7572
Practice Address - Fax:575-391-7576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-01
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric PsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMNM100110OtherVALUE OPTIONS OF NM
NM09498Medicaid
NM2-13759-3Medicare PIN
NM09498Medicaid