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Individual

ALEKSANDR G GAZAROV

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
101 LIVINGSTON LOOP, BLDG C, SUITE 3, SANTA TERESA, NM 88008-9442
(575) 589-2022
(575) 589-2605
Mailing address
101 LIVINGSTON LOOP, BLDG C, SUITE 3, SANTA TERESA, NM 88008-9753
(575) 589-2025
(575) 589-2605

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD2004-0757
NM

Other

Enumeration date
10/23/2006
Last updated
05/11/2012
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