1376338996 NPI number — MOHAMED JAMAL A. ABDELMONIM ATTIA M.D.

Table of content: MOHAMED JAMAL A. ABDELMONIM ATTIA M.D. (NPI 1376338996)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376338996 NPI number — MOHAMED JAMAL A. ABDELMONIM ATTIA M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ATTIA
Provider First Name:
MOHAMED
Provider Middle Name:
JAMAL A. ABDELMONIM
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1376338996
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/14/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4351 E LOHMAN AVENUE
Provider Second Line Business Mailing Address:
SUITE 300
Provider Business Mailing Address City Name:
LAS CRUCES
Provider Business Mailing Address State Name:
NM
Provider Business Mailing Address Postal Code:
88011
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
575-556-7600
Provider Business Mailing Address Fax Number:
575-556-7169

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4351 E LOHMAN AVENUE
Provider Second Line Business Practice Location Address:
SUITE 300
Provider Business Practice Location Address City Name:
LAS CRUCES
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
88011
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
575-556-7600
Provider Business Practice Location Address Fax Number:
575-556-7169
Provider Enumeration Date:
04/14/2025

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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