Provider Demographics
NPI:1194841254
Name:SINGH, ABHINAV (MD)
Entity Type:Individual
Prefix:
First Name:ABHINAV
Middle Name:
Last Name:SINGH
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 1:211 SUDDERTH DRIVE/ PO BOX 800
Mailing Address - Street 2:LINCOLN COUNTY MEDICAL CENTER
Mailing Address - City:RUIDOSO
Mailing Address - State:NM
Mailing Address - Zip Code:88345
Mailing Address - Country:US
Mailing Address - Phone:575-630-4230
Mailing Address - Fax:575-630-4237
Practice Address - Street 1:211 SUDDERTH DRIVE
Practice Address - Street 2:LINCOLN COUNTY MEDICAL CENTER
Practice Address - City:RUIDOSO
Practice Address - State:NM
Practice Address - Zip Code:88345
Practice Address - Country:US
Practice Address - Phone:575-630-4230
Practice Address - Fax:575-630-4237
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2013-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2007-0021207R00000X
VA0101242709207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMNM002R09OtherBCBS
NM25107089Medicaid
NM25107089Medicaid