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General NPI Number Information
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NPI Number | 1942554480
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Entity Type | Organization
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Legal Business Name | SANDYA SURGICAL ASSOCIATES
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Dates
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Enumeration Date | 11/06/2012
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Last Update Date | 02/13/2013
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Provider Practice Location Address
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Address Line | 2402 W PIERCE ST SUITE 5C
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City | CARLSBAD
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State | NM
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Zip | 88220-3537
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Country | US
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Telephone | 575-725-5755
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Fax |
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Provider Business Mailing Address
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Address Line | 2402 W PIERCE ST SUITE 5C
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City | CARLSBAD
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State | NM
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Zip | 88220-3537
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Country | US
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Telephone | 575-725-5755
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MURUGAN ATHIGAMAN
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Credential | M.D.
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Telephone | 575-725-5755
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 20020399
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 2002-0399
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License Number State | NM
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