Basic Information
Provider Information
NPI: 1316119399
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SARANGARM
FirstName: DUSADEE
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 933 BRADBURY DR SE
Address2: SUITE 2222
City: ALBUQUERQUE
State: NM
PostalCode: 871064374
CountryCode: US
TelephoneNumber: 5052723120
FaxNumber: 5052728060
Practice Location
Address1: UNM DEPARTMENT OF EMERGENCY MEDICINE
Address2: MSC11 6025, 1 UNIVERSITY OF NEW MEXICO
City: ALBUQUERQUE
State: NM
PostalCode: 871310001
CountryCode: US
TelephoneNumber: 5052725062
FaxNumber: 5059257290
Other Information
ProviderEnumerationDate: 03/30/2008
LastUpdateDate: 12/22/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000XMD2010-0526NMY Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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