Individual
DR. LAURENCE SHANDLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
901 W ALAMEDA ST STE 25, SANTA FE, NM 87501-1673
(505) 988-8869
(505) 982-6298
Mailing address
1418 LUISA STREET, SUITE 5, SANTA FE, NM 87505
(505) 690-8436
(505) 984-8967
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
72227
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
25754
—
NM
01
—
72227
NM BOARD OF MEDICINE
NM
01
—
CS00007212
NM BOARD OF PHARMACY
NM
Enumeration date
10/04/2006
Last updated
11/07/2019
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