Individual
KARTHIK KAVASSERI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
ROUTE 301 NORTH, ZUNI, NM 87327
(505) 782-4431
(505) 782-4502
Mailing address
PO BOX 467, ZUNI, NM 87327-0467
(505) 782-4431
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD2017-0166
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1320751
—
NM
Enumeration date
06/30/2014
Last updated
10/21/2019
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