Organization
GALISTEO ADVANCED GYNECOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN SUMMERS MBA (PRACTICE MANAGER)
(505) 992-3290
Entity
Organization
Contact information
Practice address
1691 GALISTEO ST, SUITE D, SANTA FE, NM 87505-4780
(505) 984-2300
(505) 988-1940
Mailing address
1691 GALISTEO ST, SUITE D, SANTA FE, NM 87505-4780
(505) 984-2300
(505) 988-1940
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
82295
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
46813
—
NM
Enumeration date
10/10/2007
Last updated
10/10/2007
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