Provider Demographics
NPI:1215525902
Name:VOJDANI, AUGUST (PA-C)
Entity type:Individual
Prefix:
First Name:AUGUST
Middle Name:
Last Name:VOJDANI
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 26666
Mailing Address - Street 2:PHS PROVIDER ENROLLMENT
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87125-6666
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4588 PARADISE BLVD NW
Practice Address - Street 2:MEDICARE ADVANTAGE CLINIC
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87114-4105
Practice Address - Country:US
Practice Address - Phone:505-998-1840
Practice Address - Fax:505-998-1841
Is Sole Proprietor?:No
Enumeration Date:2021-01-07
Last Update Date:2025-04-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NMPA2022-0090363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant