Endovascular
Organization Active NPI Surgery Physician · Gallup, NM
NPI 1972221182 · NPPES record last updated Sep 8, 2022
Key facts
- NPI
- 1972221182
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Surgery Physician 208600000X
- Legal business name
- ENDOVASCULAR
- Practice address
- 2240 College Dr
Gallup, NM 87301-7003 - Phone
- (505) 297-1052
- Fax
- (505) 297-1227
- NPI assigned
- Aug 15, 2022
- Organization subpart
- No
Authorized official
- Name
- Kiup Alexander Kim, MD
- Title
- Chief Medical Officer
- Phone
- (480) 584-2369
Practitioners 1
-
Kiup Alexander Kim, MD, RPVI
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obesity Medicine (Family Medicine) Physician |
207QB0002X | |||
| Surgery Physician |
208600000X | Yes | ||
| Foot & Ankle Surgery Podiatrist |
213ES0103X |
Addresses
Primary practice location
2240 College Dr
Gallup, NM 87301-7003
Mailing address
202 E Earll Dr Ste 360
Phoenix, AZ 85012-2677
Phone (480) 788-5621
Other names
- Endovascular
Other providers in Gallup, NM
- Edith Patricia Elsner-Ridgeway
- Brian Dale Elza
- Susan Emerson-Betti
- Wisan Encarnacion
- Enchantment Home Healthcare, LLC
- Kaila England
- Brenda Sue Ennis
- Clarence Aaron Enos
- Alvera Jean Enote
- Dorothy L Enote
All providers in Gallup, NM · Surgery Physician in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 8, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.