Provider Demographics
NPI:1114410610
Name:BAROUHAS, IVANA IVELISSE (MD)
Entity type:Individual
Prefix:DR
First Name:IVANA
Middle Name:IVELISSE
Last Name:BAROUHAS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:MSC10 5580 1 UNIVERSITY OF NEW MEXICO
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87131-0001
Mailing Address - Country:US
Mailing Address - Phone:505-272-5580
Mailing Address - Fax:505-272-6385
Practice Address - Street 1:MSC10 5580 1 UNIVERSITY OF NEW MEXICO
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87131-0001
Practice Address - Country:US
Practice Address - Phone:505-272-5580
Practice Address - Fax:505-272-6385
Is Sole Proprietor?:No
Enumeration Date:2018-06-08
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL125.072188207V00000X
NM390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology