EDGAR R CORDIVIN MD NPI 1992760250

NPI Information

Edgar R Cordivin, MD is a diagnostic radiology radiology in Gallup, NM with 43 years of experience. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. Edgar R Cordivin, MD NPI is 1992760250. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIFORMED SERVICES UHS FE HEBERT SCHOOL OF MED
Graduation Year:1981

The provider's business location address is:

516 EAST NIZHONI BLVD.
GALLUP, NM
ZIP 87301-337
Phone: (505) 722-1000
Fax: (505) 722-1192

The NPI 1992760250 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 4/19/2006 and was last updated on 4/9/2014.

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:

Other Identifiers

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

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