Healthcare Provider Details

I. General information

NPI: 1871728840
Provider Name (Legal Business Name): WOMEN'S CANCER AND SURGICAL CARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2009
Last Update Date: 07/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4610 JEFFERSON LN NE
ALBUQUERQUE NM
87109-2117
US

IV. Provider business mailing address

4610 JEFFERSON LN NE
ALBUQUERQUE NM
87109-2117
US

V. Phone/Fax

Practice location:
  • Phone: 505-559-4495
  • Fax: 505-842-8025
Mailing address:
  • Phone: 505-559-4495
  • Fax: 505-842-8025

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. DANIEL G RAMIREZ
Title or Position: OFFICE MANAGER
Credential:
Phone: 505-559-4495