ELISHA PRAVETA MAHILAL

ALBUQUERQUE, NM
NPI1528681095
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy207Q00000X Family Medicine
(Licence: NM  MD2023-0620)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
(Licence: FL  TRN30313)
Enumeration Date2020-05-19
Last Update Date2023-07-12
Business Address
ELISHA PRAVETA MAHILAL MD
1100 CENTRAL AVE SE
ALBUQUERQUE, NM 87106-4930
Phone number: 505-724-6124
Mailing Address
ELISHA PRAVETA MAHILAL MD
PO BOX 26666 PROVIDER ENROLLMENT
ALBUQUERQUE, NM 87125-6666
Phone number: 505-923-6770