Organization
ST. VINCENT HOSPITAL
Active
Other names
St. Vincent Hospitalists Group
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE TASSIN (PRESIDENT CEO)
(505) 913-5202
Entity
Organization
Contact information
Practice address
455 SAINT MICHAELS DR, SANTA FE, NM 87505-7601
(505) 989-6130
(505) 913-5408
Mailing address
455 SAINT MICHAELS DR, SANTA FE, NM 87505-7601
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
—
2086S0127X
Trauma Surgery Physician
—
—
208M00000X
Hospitalist Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
45690
—
NM
Enumeration date
07/06/2007
Last updated
11/24/2014
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