Individual
RAJAN K MIRCHANDANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1010 SPRUCE ST, ESPANOLA HOSPITAL PMG CLINIC, ESPANOLA, NM 87532-2724
(505) 367-0340
(505) 367-4470
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-5356
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2000328
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
E7565
—
NM
Enumeration date
10/03/2006
Last updated
06/12/2012
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