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Individual

BISHNU RAUTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4351 E LOHMAN AVE, STE 209, LAS CRUCES, NM 88011-8259
(505) 522-5944
(505) 522-0636
Mailing address
1836 LACKLAND HILL PKWY, ATTNT: CREDENTIALING DEPARTMENT, SAINT LOUIS, MO 63146-3572
(314) 989-0300
(314) 810-1399

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
91288
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
43398
NM
Enumeration date
09/20/2006
Last updated
07/08/2007
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