Healthcare Provider Details

I. General information

NPI: 1770149189
Provider Name (Legal Business Name): ARSHAD NAVEED AHSANUDDIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2019
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 WOODWARD PL NE
ALBUQUERQUE NM
87102-2705
US

IV. Provider business mailing address

200 MULBERRY ST NE UNIT 3001
ALBUQUERQUE NM
87106-4768
US

V. Phone/Fax

Practice location:
  • Phone: 505-938-8888
  • Fax:
Mailing address:
  • Phone: 865-271-8871
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0105X
TaxonomyClinical Pathology/Laboratory Medicine Physician
License NumberMD2026-0632
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: