Individual
PETER K. SANGRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5055 MCNUTT RD, SANTA TERESA, NM 88008-9442
(575) 589-3000
(575) 589-6682
Mailing address
5045 MCNUTT RD, SANTA TERESA, NM 88008-9442
(575) 589-3000
(575) 589-6682
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD2017-0955
NM
2084P0804X
Child & Adolescent Psychiatry Physician
MD2017-0955
NM
Other
Enumeration date
07/10/2013
Last updated
10/09/2020
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