Healthcare Provider Details

I. General information

NPI: 1780063347
Provider Name (Legal Business Name): AHMED H ALAINI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2015
Last Update Date: 09/08/2024
Certification Date: 09/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5981 JEFFERSON ST NE STE A
ALBUQUERQUE NM
87109-3457
US

IV. Provider business mailing address

717 ENCINO PL NE STE 10
ALBUQUERQUE NM
87102-2626
US

V. Phone/Fax

Practice location:
  • Phone: 505-370-9600
  • Fax: 505-355-0566
Mailing address:
  • Phone: 505-531-5559
  • Fax: 505-666-5859

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberMD20180918
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberMD2018-0918
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: