Individual
TUSHAR P DANDADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2400 UNSER BLVD SE, SUITE 18200, RIO RANCHO, NM 87124-4740
(505) 253-6200
(505) 253-6201
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
2003-0526
NM
207VX0000X
Obstetrics Physician
Primary
20030526
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65030231
—
NM
Enumeration date
10/03/2006
Last updated
08/28/2014
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