DR. CATHERINE MARIE RADOVICH M.D. NPI 1699743328

NPI Information

NPI: 1699743328
Provider Name: DR. CATHERINE MARIE RADOVICH, M.D.
Classification: General Practice - 208D00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
516 NIZHONI BLVD
GALLUP INDIAN MEDICAL CENTER
GALLUP, NM
ZIP 87301
Phone: (505) 722-1000
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DR. Catherine Marie Radovich, M.D. is a general practice in Gallup, NM. DR. Catherine Marie Radovich, M.D. NPI is 1699743328. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

516 NIZHONI BLVD
GALLUP INDIAN MEDICAL CENTER
GALLUP, NM
ZIP 87301-555
Phone: (505) 722-1000

The NPI 1699743328 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/9/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208D00000X	General Practice		91287	NEW MEXICO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	S0796	MEDICAID	NEW MEXICO
2	H37698	MEDICARE UPIN	NEW MEXICO
3	8HZ143	MEDICARE ID-TYPE UNSPECIFIED	NEW MEXICO
4	414904	MEDICAID	ARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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