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General NPI Number Information
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NPI Number | 1255645008
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Entity Type | Individual
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Provider Name | BHARATI SUKADEO KALYANI M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/04/2010
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Last Update Date | 07/11/2024
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Provider Practice Location Address
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Address Line | 4371 E LOHMAN AVE
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City | LAS CRUCES
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State | NM
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Zip | 88011-8255
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Country | US
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Telephone | 606-422-9158
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Fax |
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Provider Business Mailing Address
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Address Line | 2842 LOOKOUT RIDGE DR
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City | LAS CRUCES
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State | NM
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Zip | 88011-0813
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Country | US
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Telephone | 606-422-9158
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 4543
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | NM2016-0063
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License Number State | NM
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Taxonomy #3
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 257734
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License Number State | MA
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Taxonomy #4
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Taxonomy Code | 207XX0004X
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Taxonomy Name | Orthopaedic Foot and Ankle Surgery Physician
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License Number | MD20160063
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License Number State | NM
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Taxonomy #5
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | MD2016-0063
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License Number State | NM
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