Mark Elliott Walden, M.D
Individual provider Active NPI General Practice Physician · Raton, NM
NPI 1831213248 · NPPES record last updated Apr 5, 2011
Key facts
- NPI
- 1831213248
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Physician 208D00000X
- License
- D0044433 (MD)
- Practice address
- 190 Hospital Drive
Raton, NM 87740 - Phone
- (575) 445-5563
- Fax
- (575) 445-5566
- NPI assigned
- Mar 19, 2007
- 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)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0044433 | MD | MD | General Practice Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | D0044433 | MD | Yes |
Addresses
Primary practice location
190 Hospital Drive
Raton, NM 87740
Mailing address
190 Hospital Dr
Raton, NM 87740-2002
Phone (575) 445-5563
Other providers in Raton, NM
- Sonya Marie Villani
- Dalena Visarriagas
- Hector R Vrdin Jr.
- Kathleen A Vukonich
- Zachary Wainwright
- Anne Marie Walton
- Christina J Warder
- Bruce Wayne Washburn
- Crystal Dawn Washburn
- Heather Welborn
All providers in Raton, NM · General Practice 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 Apr 5, 2011. 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.