Individual
DR. KUSUM R PRABHAKAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1336 WYOMING BLVD NE, SUITE F, ALBUQUERQUE, NM 87112-5066
(505) 275-2442
(505) 275-2443
Mailing address
1336 WYOMING BLVD NE, SUITE F, ALBUQUERQUE, NM 87112-5066
(505) 275-2442
(505) 275-2443
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
77-234
NM
Other
Enumeration date
07/10/2006
Last updated
07/08/2007
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