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Individual

MRUNAL TAILOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
8020 CONSTITUTION PL NE STE 202, ALBUQUERQUE, NM 87110-7640
(505) 998-3096
(505) 998-3100
Mailing address
8020 CONSTITUTION PL NE STE 202, ALBUQUERQUE, NM 87110-7640
(505) 998-3096
(505) 998-3100

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
A167214
CA
2085R0202X
Diagnostic Radiology Physician
Primary
MD2021-0251
NM
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
86804537
NM
Enumeration date
03/23/2015
Last updated
04/23/2025
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