IndividualActive
Mariam Bokolishvili, S.A.
NPI 1225564800 · Surgical Physician Assistant · Santa Fe, NM
Provider details
- NPI number
- 1225564800
- Entity type
- Individual
- Primary specialty
- Surgical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- S.A.
- Sex
- Female
- Sole proprietor
- Yes
- License
- 15-489
Mailing address
1511 W Alameda St
Santa Fe, NM 87501-1746
Registry dates
- Enumerated
- 2017-05-03
- Last updated
- 2018-05-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.