DAVID GUSTAD DEVITRE

FARMINGTON, NM
NPI1851595912
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207R00000X Internal Medicine
(Licence: NM  A-1522-09)
Additional Taxonomies207R00000X Internal Medicine
(Licence: MO  2007006876)
208000000X Pediatrics
(Licence: MO  2007006876)
208000000X Pediatrics
(Licence: NM  A-1522-09)
Enumeration Date2007-06-13
Last Update Date2010-01-07
Business Address
Mr. DAVID GUSTAD DEVITRE DO
801 W MAPLE ST
FARMINGTON, NM 87401-5630
Phone number: 505-609-6463
Mailing Address
Mr. DAVID GUSTAD DEVITRE DO
PO BOX 6210
FARMINGTON, NM 87499-6210
Phone number: 505-609-2258
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