Provider Demographics
NPI:1619146966
Name:PEREZ-LEDEZMA, CLAUDIO (MD)
Entity Type:Individual
Prefix:
First Name:CLAUDIO
Middle Name:
Last Name:PEREZ-LEDEZMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3821 MASTHEAD ST NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-4679
Mailing Address - Country:US
Mailing Address - Phone:505-998-7401
Mailing Address - Fax:505-998-7740
Practice Address - Street 1:3900 E LOHMAN AVE STE B
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-8268
Practice Address - Country:US
Practice Address - Phone:575-522-5752
Practice Address - Fax:575-522-5722
Is Sole Proprietor?:No
Enumeration Date:2008-02-20
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2009-0775207Q00000X, 207RN0300X
IN01078003A207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM72332263Medicaid