MARIAM H BOKOLISHVILI S.A. NPI 1225564800

NPI Information

NPI: 1225564800
Provider Name: MARIAM H BOKOLISHVILI, S.A.
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

Address:
1511 W ALAMEDA ST
SANTA FE, NM
ZIP 87501
Phone: (505) 459-3988
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Mariam H Bokolishvili, S.A. is a surgical physician assistant in Santa Fe, NM. Mariam H Bokolishvili, S.A. NPI is 1225564800. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1511 W ALAMEDA ST
SANTA FE, NM
ZIP 87501-746
Phone: (505) 459-3988

The enumeration date for this NPI number is 5/3/2017 and was last updated on 5/9/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	246ZC0007X	Specialist/Technologist, Other	Surgical Assistant	15-489		No
2	363AS0400X	Physician Assistant	Surgical	15-489		Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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