Organization · Type 2 NPI

San Miguel Clinic Corp

Family Medicine Physician · Las Vegas, NM

NPI number 1114920717 Active

Practice location

108 Legion Dr Ste A
Las Vegas, NM 87701-4898

Mailing address

PO Box 18428
Belfast, ME 04915-4079

Specialties and licenses

TaxonomyCodeLicense
Family Medicine Physician Primary 207Q00000XNone listed

Family Medicine Physician: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

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About NPI 1114920717

San Miguel Clinic Corp's National Provider Identifier is 1114920717, issued on May 27, 2005. The primary taxonomy on file is Family Medicine Physician (207Q00000X), and the practice location is in Las Vegas, NM. The record was last updated on Sep 28, 2026.