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
Fax: (575) 521-3216
Website:

Health care specialties

SpecialtyCodeLicense #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 13 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.

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Identifiers

StateTypeNumberIssuer
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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