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Organization
PETER SANGRA MD LLC
Active
Organization
PETER SANGRA MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER SANGRA MD (OWNER)
(404) 513-2350
Entity
Organization
Contact information
Practice address
5055 MCNUTT RD, SANTA TERESA, NM 88008-9442
(575) 589-3000
Mailing address
2004 BOY SCOUT LN, SUNLAND PARK, NM 88063-9500
(404) 513-2350
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
—
NULL
2084P0800X
Psychiatry Physician
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
—
NULL
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
—
—
Other
Enumeration date
07/13/2020
Last updated
07/13/2020
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