Provider Demographics
NPI:1609258656
Name:UNIVERSITY OF NEW MEXICO
Entity Type:Organization
Organization Name:UNIVERSITY OF NEW MEXICO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMED MAHER
Authorized Official - Middle Name:
Authorized Official - Last Name:HULOU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-745-1137
Mailing Address - Street 1:9125 COPPER AVE NE APT 617
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87123-1077
Mailing Address - Country:US
Mailing Address - Phone:281-745-1137
Mailing Address - Fax:
Practice Address - Street 1:9125 COPPER AVE NE APT 617
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87123-1077
Practice Address - Country:US
Practice Address - Phone:281-745-1137
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-26
Last Update Date:2016-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes284300000XHospitalsSpecial Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY0291OtherUK
KY0291OtherUK