Organization
SANTA FE MEDICAL GROUP, LLC
Active
Other names
Taos Urgent Care
Organization subpart
No
Provider details
NPI number
Authorized official
LISA GURULE (CREDENTIALING SPECIALIST)
(505) 474-6097
Entity
Organization
Contact information
Practice address
330 UNIT C, PASEO DEL PUEBLO SUR, TAOS, NM 87571
(575) 758-1414
(575) 758-1474
Mailing address
330 UNIT C, PASEO DEL PUEBLO SUR, TAOS, NM 87571
(575) 758-1414
(575) 758-1474
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD2005-0796
NM
Other
Enumeration date
04/23/2010
Last updated
04/23/2010
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