Provider Demographics
NPI:1124118963
Name:FERRARO, ROBERT THOMAS (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:THOMAS
Last Name:FERRARO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5501 JEFFERSON ST NE
Mailing Address - Street 2:SUITE #700
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-3478
Mailing Address - Country:US
Mailing Address - Phone:505-872-1002
Mailing Address - Fax:505-888-3708
Practice Address - Street 1:5501 JEFFERSON ST NE
Practice Address - Street 2:SUITE #700
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-3478
Practice Address - Country:US
Practice Address - Phone:505-872-1002
Practice Address - Fax:505-888-3708
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM93254207RE0101X
NM93-254207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM3137OtherBCBS PROVIDER NUMBER
NM201051958OtherPRESBYTERIAN HEALTH PLAN
NM04257Medicaid
NM04257Medicaid
NMF25679Medicare UPIN
NM600521029Medicare ID - Type UnspecifiedCOMPANY NUMBER