Organization
KUSUM R PRABHAKAR MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KUSUM R PRABHAKAR M.D (PRESIDENT)
(505) 275-2442
Entity
Organization
Contact information
Practice address
1336 WYOMING BLVD NE, SUITE F, ALBUQUERQUE, NM 87112-5066
(505) 275-2442
(505) 275-2443
Mailing address
PO BOX 65605, ALBUQUERQUE, NM 87193-5605
(505) 275-2442
(505) 275-2443
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
77234
NM
Other
Enumeration date
08/17/2008
Last updated
08/19/2008
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