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General NPI Number Information
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NPI Number | 1760749600
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Entity Type | Individual
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Provider Name | SHASHWAT PANDHI M.D., M.P.H.
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Gender | Male
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Dates
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Enumeration Date | 04/17/2012
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Last Update Date | 09/17/2024
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Provider Practice Location Address
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Address Line | 6121 INDIAN SCHOOL RD NE STE 143
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City | ALBUQUERQUE
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State | NM
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Zip | 87110-3176
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Country | US
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Telephone | 505-542-4970
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Fax | 505-213-6301
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Provider Business Mailing Address
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Address Line | 6121 INDIAN SCHOOL RD NE STE 143
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City | ALBUQUERQUE
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State | NM
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Zip | 87110-3176
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Country | US
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Telephone | 505-542-4970
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Fax | 505-213-6301
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD2020-0592
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | MD2020-0592
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License Number State | NM
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Taxonomy #3
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Taxonomy Code | 2084P0802X
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Taxonomy Name | Addiction Psychiatry Physician
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License Number | MD2020-0592
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License Number State | NM
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