Nattakom, Shiney
Nattakom, Shiney is an sole proprietor health care provider with primary practice located at 166 Roadrunner Pkwy Suite 1B, Las Cruces NM 88011-7044. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Nattakom, Shiney can be contacted via phone (575) 522-2222.Contact Information
Primary practice address
166 Roadrunner Pkwy Suite 1B
Las Cruces NM 88011-7044
Phone: (575) 522-2222
Fax: (575) 521-3216
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 20050080 | New Mexico |
Profile Details
| NPI number | 1396739579 |
|---|---|
| LBN Legal business name | Nattakom, Shiney |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 2nd, 2005 |
| Last updated | Jul 19th, 2011 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1396739579 | NPPES |
| New Mexico | Other | NM009935 | BCBS |
| New Mexico | Other | 850483184 | BCBS |
| New Mexico | Other | 72676 | BCBS |
| New Mexico | MEDICAID | 50904566 | BCBS |
| New Mexico | Other | 110232565 | BCBS |
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