Bokolishvili, Mariam H

Bokolishvili, Mariam H is an sole proprietor health care provider with primary practice located at 1511 W Alameda St , Santa Fe NM 87501-1746. She recently has 2 registered licenses in different health care specialties including Technologists, Technicians & Other Technical Service Providers / Surgical Assistant, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Surgical is her primary health care specialty. Bokolishvili, Mariam H can be contacted via phone (505) 459-3988.

Contact Information

Primary practice address
1511 W Alameda St Santa Fe NM 87501-1746
Phone: (505) 459-3988
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Technologists, Technicians & Other Technical Service Providers / Surgical Assistant 246ZC0007X 15-489
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 15-489

Profile Details

NPI number 1225564800
LBN Legal business name Bokolishvili, Mariam H
Credentials S.A.
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 3rd, 2017
Last updated May 9th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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