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Individual

SHANTI BALKISSOON-CASTILLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPM

Contact information

Practice address
8300 CARMEL AVE NE STE 501, ALBUQUERQUE, NM 87122-3125
(505) 717-1274
(505) 717-1879
Mailing address
8300 CARMEL AVE NE STE 501, ALBUQUERQUE, NM 87122-3125
(505) 717-1274
(505) 717-1879

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
286
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
77777
PRESBYTERIAN HEALTH PLAN
NM
05
79774059
NM
01
NM005433
BLUE CROSS BLUE SHIELD
NM
Enumeration date
06/21/2005
Last updated
03/26/2024
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