Provider Demographics
NPI:1023405834
Name:MIHALKO, LAURA ANNE (MD)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:ANNE
Last Name:MIHALKO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:MSC 10 5610
Mailing Address - Street 2:UNIVERSITY OF NEW MEXICO
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87131-0001
Mailing Address - Country:US
Mailing Address - Phone:505-272-5505
Mailing Address - Fax:505-272-6399
Practice Address - Street 1:MSC 10 5610
Practice Address - Street 2:UNIVERSITY OF NEW MEXICO
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87131-0001
Practice Address - Country:US
Practice Address - Phone:505-272-5505
Practice Address - Fax:505-272-6399
Is Sole Proprietor?:No
Enumeration Date:2015-04-20
Last Update Date:2015-06-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NMRS2015-0368208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology