Provider Demographics
NPI:1801090485
Name:RATH, STEPHEN ANTHONY (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:ANTHONY
Last Name:RATH
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 1:1900 SUDDERTH DR
Mailing Address - Street 2:
Mailing Address - City:RUIDOSO
Mailing Address - State:NM
Mailing Address - Zip Code:88345-6117
Mailing Address - Country:US
Mailing Address - Phone:575-257-4772
Mailing Address - Fax:575-257-4775
Practice Address - Street 1:1900 SUDDERTH DR
Practice Address - Street 2:
Practice Address - City:RUIDOSO
Practice Address - State:NM
Practice Address - Zip Code:88345-6117
Practice Address - Country:US
Practice Address - Phone:575-257-4772
Practice Address - Fax:575-257-4775
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-14
Last Update Date:2014-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM6845207L00000X
NMMD2008-0112207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
2921228963OtherMYUTMB 2921228963-COMMERCIAL NUMBER