Physician Assistant, Surgical
MARIAM BOKOLISHVILI S.A.
Identity confirmed via CMS NPPES · September 30, 2026 · A directory match is not a coverage approval.
Is this your practice? This listing was imported from public provider identity data (CMS NPPES) and has not yet been claimed. Claim this listing to confirm the practice details. Plan acceptance stays unpublished until the practice reports it.
Public record
NPI 1225564800 · enumerated 2017-05-03 · record updated 2018-05-09. Source: CMS NPPES. A listing is not a TRICARE network approval.
NPPES recordGoogle Maps Apple Maps OpenStreetMap
Other names: MARIAM BOKOLISHVILI
Addresses and phones
- Mailing address 1511 W ALAMEDA ST, SANTA FE, NM, 87501-1746 (505) 459-3988 Google Maps Apple Maps OpenStreetMap
- Practice location 1511 W ALAMEDA ST, SANTA FE, NM, 87501-1746 (505) 459-3988 Google Maps Apple Maps OpenStreetMap
Specialties
- Specialist/Technologist, Other, Surgical Assistant 246ZC0007X · License 15-489
- Physician Assistant, Surgical 363AS0400X · Primary · License 15-489
In this directory
Locations and evidence
-
Practice location
SANTA FE, NM, 875011746
Accepting new patientsNot reportedCMS NPPES · September 30, 2026
Plan acceptance
- No published plan acceptance yet. Confirm directly with the practice, or claim this listing if it's yours.