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General NPI Number Information
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NPI Number | 1215292339
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Entity Type | Individual
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Provider Name | VIVEK KATUKURI M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/05/2012
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Last Update Date | 11/07/2025
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Provider Practice Location Address
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Address Line | 1 UNIVERSITY OF NEW MEXICO DEPT OF OBSTETRICS AND GYNECOLOGY MSC 10 5580
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City | ALBUQUERQUE
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State | NM
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Zip | 87131-0001
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Country | US
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Telephone | 505-272-4051
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Fax |
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Provider Business Mailing Address
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Address Line | 800 BRADBURY DR SE STE 116
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City | ALBUQUERQUE
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State | NM
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Zip | 87106-4310
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VX0000X
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Taxonomy Name | Obstetrics Physician
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License Number | MD2016-0236
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 4301100755
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 207VM0101X
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Taxonomy Name | Maternal & Fetal Medicine Physician
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License Number | MD2016-0236
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License Number State | NM
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