Provider Demographics
NPI:1871728840
Name:WOMEN'S CANCER AND SURGICAL CARE PC
Entity type:Organization
Organization Name:WOMEN'S CANCER AND SURGICAL CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:G
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-559-4495
Mailing Address - Street 1:4610 JEFFERSON LN NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-2117
Mailing Address - Country:US
Mailing Address - Phone:505-559-4495
Mailing Address - Fax:505-842-8025
Practice Address - Street 1:4610 JEFFERSON LN NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-2117
Practice Address - Country:US
Practice Address - Phone:505-559-4495
Practice Address - Fax:505-842-8025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-20
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMB2282Medicare UPIN