Organization
ADVANCED UROLOGY OF NEW MEXICO LLC
Active
Organization
ADVANCED UROLOGY OF NEW MEXICO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAVEL V. MOURACHOV MD (OWNER)
(505) 661-8500
Entity
Organization
Contact information
Practice address
3917 WEST RD, SUITE 137, LOS ALAMOS, NM 87544-2275
(505) 661-8500
(505) 661-0096
Mailing address
3917 WEST RD, SUITE 137, LOS ALAMOS, NM 87544-2275
(505) 661-8500
(505) 661-0096
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
NM
Other
Enumeration date
02/03/2011
Last updated
02/03/2011
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