Provider Demographics
NPI:1700199148
Name:FERNANDEZ-SALDIVAR, RUBEN (MD)
Entity Type:Individual
Prefix:DR
First Name:RUBEN
Middle Name:
Last Name:FERNANDEZ-SALDIVAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6401 ACADEMY RD NE APT 172
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-3320
Mailing Address - Country:US
Mailing Address - Phone:505-206-1301
Mailing Address - Fax:
Practice Address - Street 1:6401 ACADEMY RD NE APT 172
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-3320
Practice Address - Country:US
Practice Address - Phone:505-206-1301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-14
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ1003580207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine