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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