Basic Information
| Provider Information | |||||||||
| NPI: | 1194841254 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SINGH | ||||||||
| FirstName: | ABHINAV | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 211 SUDDERTH DRIVE/ PO BOX 800 | ||||||||
| Address2: | LINCOLN COUNTY MEDICAL CENTER | ||||||||
| City: | RUIDOSO | ||||||||
| State: | NM | ||||||||
| PostalCode: | 88345 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5756304230 | ||||||||
| FaxNumber: | 5756304237 | ||||||||
| Practice Location | |||||||||
| Address1: | 211 SUDDERTH DRIVE | ||||||||
| Address2: | LINCOLN COUNTY MEDICAL CENTER | ||||||||
| City: | RUIDOSO | ||||||||
| State: | NM | ||||||||
| PostalCode: | 88345 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5756304230 | ||||||||
| FaxNumber: | 5756304237 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/21/2007 | ||||||||
| LastUpdateDate: | 11/20/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD2007-0021 | NM | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 0101242709 | VA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | NM002R09 | 01 | NM | BCBS | OTHER | 25107089 | 05 | NM | MEDICAID |