Provider Demographics
NPI:1649414590
Name:SOWAR, KRISTINA S (MD)
Entity Type:Individual
Prefix:MS
First Name:KRISTINA
Middle Name:S
Last Name:SOWAR
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:933 BRADBURY DR SE
Mailing Address - Street 2:STE 2222
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-4374
Mailing Address - Country:US
Mailing Address - Phone:505-272-3120
Mailing Address - Fax:505-272-8060
Practice Address - Street 1:UNIVERSITY OF NEW MEXICO DEPT OF PSYCHIATRY
Practice Address - Street 2:MSC09 5030 1 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:505-272-5002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-22
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NMMD2011-05972084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARES000Medicare UPIN