Provider Demographics
NPI:1053676288
Name:MIRRAKHIMOV, AIBEK (MD)
Entity Type:Individual
Prefix:DR
First Name:AIBEK
Middle Name:
Last Name:MIRRAKHIMOV
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2211 LOMAS BLVD NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-2719
Mailing Address - Country:US
Mailing Address - Phone:505-272-2610
Mailing Address - Fax:
Practice Address - Street 1:DEPARTMENT OF INTERNAL MEDICINE MSC10-5550 1 UNIVERSITY
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87131
Practice Address - Country:US
Practice Address - Phone:505-272-4751
Practice Address - Fax:505-272-8700
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-13
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2022-1461207R00000X, 207L00000X
KY48294207R00000X, 208M00000X
NM390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program