Provider Demographics
NPI:1700115615
Name:OVIEDO, ERIKA M (DOM)
Entity Type:Individual
Prefix:DR
First Name:ERIKA
Middle Name:M
Last Name:OVIEDO
Suffix:
Gender:F
Credentials:DOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1261
Mailing Address - Street 2:
Mailing Address - City:ALCALDE
Mailing Address - State:NM
Mailing Address - Zip Code:87511-1261
Mailing Address - Country:US
Mailing Address - Phone:505-927-5225
Mailing Address - Fax:
Practice Address - Street 1:303C COUNTY ROAD 59
Practice Address - Street 2:
Practice Address - City:VELARDE
Practice Address - State:NM
Practice Address - Zip Code:87582
Practice Address - Country:US
Practice Address - Phone:505-927-5225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-24
Last Update Date:2009-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM991171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist