Provider Demographics
NPI:1477871598
Name:DARAG, WENDI LASHEA (MD)
Entity Type:Individual
Prefix:DR
First Name:WENDI
Middle Name:LASHEA
Last Name:DARAG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 E LOHMAN AVE STE D
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88001-3394
Mailing Address - Country:US
Mailing Address - Phone:575-652-4426
Mailing Address - Fax:575-222-0025
Practice Address - Street 1:525 E LOHMAN AVE STE D
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88001-3394
Practice Address - Country:US
Practice Address - Phone:575-652-4426
Practice Address - Fax:575-222-0025
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2013-0836207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine