Provider Demographics
NPI:1235189408
Name:NAIDA, ABUBAKAR MOHAMMED (MD)
Entity Type:Individual
Prefix:DR
First Name:ABUBAKAR
Middle Name:MOHAMMED
Last Name:NAIDA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ABUBAKAR
Other - Middle Name:MOHAMMED
Other - Last Name:NAIDA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2420 W PIERCE STREET SUITE 104
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:NM
Mailing Address - Zip Code:88220-3517
Mailing Address - Country:US
Mailing Address - Phone:575-885-0805
Mailing Address - Fax:575-885-0793
Practice Address - Street 1:2420 W PIERCE STREET SUITE 104
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:NM
Practice Address - Zip Code:88220-3517
Practice Address - Country:US
Practice Address - Phone:575-885-0805
Practice Address - Fax:575-885-0793
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2016-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
TN403932080N0001X
NMMD2015-0544208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No174400000XOther Service ProvidersSpecialist
No2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM83001387Medicaid
NM83001387Medicaid
NM461825YKTNMedicare PIN