Individual
AJIT S TIPIRNENI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5400 GIBSON BLVD SE, ALBUQUERQUE, NM 87108
(505) 262-7905
(505) 262-7217
Mailing address
PO BOX 27829, ALBUQUERQUE, NM 87125
(505) 232-1920
(505) 727-9276
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
20020240
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6608515
—
NM
Enumeration date
07/08/2006
Last updated
07/08/2007
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