Healthcare Provider Details

I. General information

NPI: 1376338996
Provider Name (Legal Business Name): MOHAMED JAMAL A. ABDELMONIM ATTIA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2025
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date: 01/06/2026
Reactivation Date: 01/09/2026

III. Provider practice location address

4351 E LOHMAN AVENUE SUITE 300
LAS CRUCES NM
88011
US

IV. Provider business mailing address

4351 E LOHMAN AVENUE SUITE 300
LAS CRUCES NM
88011
US

V. Phone/Fax

Practice location:
  • Phone: 575-556-7600
  • Fax: 575-556-7169
Mailing address:
  • Phone: 575-556-7600
  • Fax: 575-556-7169

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: