Organization
BHASKER MEDICAL CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADDY BHASKER (ADMINISTRATOR)
(575) 835-2940
Entity
Organization
Contact information
Practice address
200 NEEL AVE, SOCORRO, NM 87801-4649
(575) 835-2940
(575) 835-2216
Mailing address
200 NEEL AVE, SOCORRO, NM 87801-4649
(575) 835-2940
(575) 835-2216
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201051377
PREJB
NM
05
—
44073
—
NM
Enumeration date
09/28/2006
Last updated
09/09/2015
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