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Individual

CHITRA NEELA SAMBASIVAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
201 CEDAR ST SE STE 306, ALBUQUERQUE, NM 87106-4932
(505) 563-1000
(505) 563-1010
Mailing address
PO BOX 26666, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
(505) 923-5354

Taxonomy

Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
073145
GA
208C00000X
Colon & Rectal Surgery Physician
Primary
MD2019-0058
NM
208C00000X
Colon & Rectal Surgery Physician
Q9019
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
14585898
NM
05
363817302
TX
05
363817303
TX
Enumeration date
05/08/2007
Last updated
03/29/2019
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