Individual
SRIRENGAM MURALIDHASAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1605 EL PASEO RD, LAS CRUCES, NM 88001-6010
(575) 523-5400
(575) 523-5401
Mailing address
1605 EL PASEO RD, LAS CRUCES, NM 88001-6010
(575) 523-5400
(575) 523-5401
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
98-125
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41326857
—
NM
01
—
P00212854
RR MEDICARE
NM
Enumeration date
08/22/2005
Last updated
05/01/2018
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