Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 2003-0526 | NM |
Y | 207VX0000X | Obstetrician | 20030526 | NM |
NPI | 1477647840 |
---|---|
Provider Name | Tushar P Dandade |
First Address | Albuquerque, NM 87125-6666 |
Second Address | Rio Rancho, NM 87124-4740 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 28/08/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
65030231 | (05) | NM |
H94961 | (02) |