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General NPI Number Information
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NPI Number | 1477173219
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF NEW MEXICO HOSPITALS
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Dates
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Enumeration Date | 04/22/2020
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Last Update Date | 04/22/2020
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Provider Practice Location Address
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Address Line | 2211 LOMAS BLVD NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87106-2719
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Country | US
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Telephone | 520-237-2545
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Fax |
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Provider Business Mailing Address
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Address Line | 2211 LOMAS BLVD NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87106-2719
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Country | US
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Telephone | 520-237-2545
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Fax |
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Authorized Official
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Title or Position | CMO AMBULATORY
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Name | DR. SIREESHA KOPPULA
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Credential | MD,MBA,MPH
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Telephone | 520-237-2545
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State |
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