Individual
MR. NICK BALARAMA RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AA
Contact information
Practice address
615 S NEW BALLAS RD DEPT OF, SAINT LOUIS, MO 63141-8221
(636) 386-9224
(636) 386-7679
Mailing address
800 BRADBURY DR SE STE 116, ALBUQUERQUE, NM 87106-4310
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
AA2024-0006
NM
367H00000X
Anesthesiologist Assistant
PENDING
MO
Other
Enumeration date
06/30/2023
Last updated
03/04/2026
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