Healthcare Provider Details

I. General information

NPI: 1962195024
Provider Name (Legal Business Name): MUAWIA SUFFYAN BAKER ABUJABER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2023
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2669 SCENIC DR
ALAMOGORDO NM
88310-8700
US

IV. Provider business mailing address

2669 SCENIC DR
ALAMOGORDO NM
88310-8700
US

V. Phone/Fax

Practice location:
  • Phone: 575-439-6200
  • Fax:
Mailing address:
  • Phone: 575-439-6100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD2026-0529
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: