MARIAM H BOKOLISHVILI


Address: 1511 W Alameda St, Santa Fe, NM 87501-1746
Phone: 5054593988

MARIAM H BOKOLISHVILI (NPI# 1225564800) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1225564800
Entity Type Individual
Full Name MARIAM H BOKOLISHVILI
Other Name MARIAM BOKOLISHVILI
Credential S.A.
Practice Address 1511 W Alameda St
Santa Fe
NM 87501-1746
Practice Telephone 5054593988
Mailing Telephone 5054593988
Enumeration Date 2017-05-03
Last Update Date 2018-05-09
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AS0400X Physician Assistant
Specialization: Surgical Technologist
15-489 Physician Assistants & Advanced Practice Nursing Providers
N 246ZC0007X Specialist/Technologist, Other
Specialization: Surgical Assistant
15-489 Technologists, Technicians & Other Technical Service Providers

Office Location

Street Address 1511 W ALAMEDA ST
City SANTA FE
State NM
Zip Code 87501-1746

Providers in the same zip code

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1841775327 Rasanjana Bhandari Behavior Technician 1505 Paseo De Conquistadora, Santa Fe, NM 87501 2018-10-01
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1831557891 Jane Berger Social Worker 300 Griffin St Ste 213, Santa Fe, NM 87501 2016-02-05
1316325061 Serenity Wellness Center of Santa Fe, LLC Counselor 343 E Palace Ave, Santa Fe, NM 87501 2015-05-14
1902209497 Mdlive Medical Group Nm LLC Counselor 123 Marcy Street, Santa Fe, NM 87501 2014-09-29
1396154183 Julie Price Counselor 1 Montoya Cir, Santa Fe, NM 87501 2014-08-06
1053609487 Michael Shawn Haner Acupuncturist 909 Early St., Santa Fe, NM 87501 2011-07-19
1396045316 Dana Moore Counselor 950 Canyon Rd., Santa Fe, NM 87501 2010-10-25
1720394232 Susan Nelsen Social Worker 118 Huddleson St, Santa Fe, NM 87501 2010-08-20
1033434543 Anthony R Moya Social Worker 501 Franklin Ave Ofc 6, Santa Fe, NM 87501 2010-03-29
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Taxonomy Information

Taxonomy Code 363AS0400X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Surgical Technologist

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1699272633 Walter Barney Physician Assistant 708 Luna Vis, Santa Fe, NM 87506-2003 2018-04-06
1508161936 New Mexico Surgical Assisting, Inc Physician Assistant 1505 Kachina Ridge Dr, Santa Fe, NM 87507-5172 2011-01-15
1861049918 Waltor Surgical Assisting Physician Assistant 708 Luna Vista, Santa Fe, NM 87506 2019-08-23

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1295191351 Duke City Surgical Assisting LLC Physician Assistant 28 Valle Lindo Rd, Peralta, NM 87042-8230 2016-01-05
1396121505 Regina Gantt Physician Assistant 28 Valle Lindo Road, Peralta, NM 87042 2015-08-11
1013398072 Lauren Soules Physician Assistant 3615 Highway 528 Nw, Albuquerque, NM 87114-8919 2015-06-16
1447666508 Audrey Rich Physician Assistant 201 Cedar Ave, Albuquerque, NM 87106 2014-07-09
1104178813 Adam M Newman Physician Assistant University of New Mexico Hospital Department, Msc 10 5610, 1 University of New Mexico, Albuquerque, NM 87131-0001 2012-10-04
1255682944 Armstrong Medical LLC Physician Assistant 13170 Central Ave Se, Suite B 345, Albuquerque, NM 87123 2012-09-21
1033494992 Sandra Seward Physician Assistant 11 Calle Pinon, Placitas, NM 87043-9316 2011-10-11
1033386420 Patrick Keenan Shanley Physician Assistant 1219 Gusdorf Rd Ste A, Taos, NM 87571-6499 2008-05-14
1982818860 Kristen Marron Bushnell Physician Assistant Pmg At 8300 Constitution - General Surgery, 8300 Constitution Ave Ne, Albuquerque, NM 87110 2007-05-09
1629092457 David A Mcculloch Physician Assistant 1501 San Pedro, Se, Va Medical Center, Albuquerque, NM 87108 2006-07-26
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Competitor

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City SANTA FE
Zip Code 87501

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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