NPI 1104245562

Benjamin Vidalis, MD

Practitioner Neurological Surgery Physician Santa Fe, NM

Practice location

Address: 465 Saint Michaels Dr STE 107, Santa Fe, NM 87505-7690
Phone: (505) 988-3233
Fax: (505) 988-3562
Mailing address: Msc 10 5615 University of New Mexico, Albuquerque, NM 87131-0001

Registered specialties (2)

Neurological Surgery Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207T00000X Licence MD2021-0303 (NM)

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Student in an Organized Health Care Education/Training Program

Student, Health Care Taxonomy 390200000X

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Registry record

NPI: 1104245562
Entity type: Individual
Sex (as registered): Male
NPI issued: 14 Apr 2014
Record last updated: 21 Sep 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.