MR. ALEKSANDR VOLK SERGOJAN (NPI# 1811529969) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1811529969 |
Entity Type | Individual |
Full Name | MR. ALEKSANDR VOLK SERGOJAN |
Credential | SO-IDC |
Practice Address |
8810 South St Se Albuquerque NM 87117-0001 |
Mailing Address |
2734 Hyder Ave Se Albuquerque NM 87106-3033 |
Practice Telephone | 5058462761 |
Mailing Telephone | 5058462761 |
Enumeration Date | 2020-02-06 |
Last Update Date | 2020-02-06 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1710I1002X |
Military Health Care Provider Specialization: Independent Duty Corpsman |
Other Service Providers |
Street Address |
8810 SOUTH ST SE |
City | ALBUQUERQUE |
State | NM |
Zip Code | 87117-0001 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1245614544 | Rowland Coyle | Military Health Care Provider | 701 Stephen Moody Rd, Albuquerque, NM 87117 | 2015-07-16 |
1649619511 | National Vision Optical | Technician/Technologist | 7901 Gibson Blvd, Bldg 20176, Kirtland, NM 87117 | 2013-06-24 |
1437493020 | Sarah Michael Workman | Nurse Practitioner | 1501 San Pedro Drive Se, Bld 47, 377mdg/mdos/sgow, Albuquerque, NM 87117 | 2012-11-20 |
1871852210 | Sunland Optical Co., Inc. | Eyewear Supplier (Equipment, not the service) | Kirtland Afb Building 20170, Albuquerque, NM 87117 | 2012-05-04 |
1528180502 | Gay C Davis | Speech-Language Pathologist | 25000 East Kirtland Afb, Wherry Es, Albuquerque, NM 87117 | 2007-04-03 |
1952493017 | Angela Marie Albrecht | Family Medicine | 377 Medical Group 2050 A Second St Se, Albuquerque, NM 87117 | 2006-09-28 |
1104930734 | Lesley Dale Pacheco | Social Worker | 2050 A 2nd Street, Kirtland Afb, NM 87117 | 2006-08-19 |
1053355735 | Joseph Agage Ouma | Family Medicine | 377th Mdg, Kirtland Afb, 2050 A Second St, Se, Albuquerque, NM 87117 | 2006-06-15 |
1033762927 | Mary Mauldin | Registered Nurse | 1515 Eubank Blvd, Albuquerque, NM 87117 | 2019-07-19 |
1811540834 | Angie Leigh Avila-quigley | Registered Nurse | 1515 Eubank, Albuquerque, NM 87117 | 2019-07-18 |
Find all providers in zip 87117 |
Taxonomy Code | 1710I1002X |
Grouping | Other Service Providers |
Classification | Military Health Care Provider |
Specialization | Independent Duty Corpsman |
A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals. |
Notes: Source: Bureau of Medicine and Surgery, Department of the Navy [7/1/2005: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1528379732 | Raquel Shelly Solivan | Military Health Care Provider | 49th Medical Group/sgpf, 280 First Street, Bldg 23, Holloman Afb, NM 88330-8273 | 2010-06-23 |
1467686154 | Hayley Michelle Crandall | Military Health Care Provider | 49th Medical Group/sgpf, 280 First Street, Bldg 23, Holloman Afb, NM 88330-8273 | 2009-05-08 |
City | ALBUQUERQUE |
Zip Code | 87117 |
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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.