Richard Dale Juel, M.D.
Individual provider Active NPI Anatomic Pathology & Clinical Pathology Physician · Tesuque, NM
NPI 1194037515 · NPPES record last updated Jul 14, 2010
Key facts
- NPI
- 1194037515
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician 207ZP0102X
- License
- 75-58 (NM)
- Practice address
- 157 Tesuque Village Rd
Tesuque, NM 87574-0829 - Phone
- (505) 955-9680
- Fax
- (505) 955-8989
- NPI assigned
- Jul 14, 2010
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 75-58 | NM | MD | Anatomic Pathology & Clinical Pathology Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 75-58 | NM | Yes |
Addresses
Primary practice location
157 Tesuque Village Rd
Tesuque, NM 87574-0829
Mailing address
PO Box 829
Tesuque, NM 87574-0829
Phone (505) 955-9680
Other providers in Tesuque, NM
- Behavioral Optometry
- Eugene L. Frank MD LLC
- Eugene L Frank
- Roberta R Goodman
- Santa Fe Mountain Center Inc
All providers in Tesuque, NM · Anatomic Pathology & Clinical Pathology Physician in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 14, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.