Healthcare Provider Details

I. General information

NPI: 1770146268
Provider Name (Legal Business Name): KARA SHAIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2019
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 UNSER BLVD SE STE 28400 OBSTETRICS AND GYNECOLOGY
RIO RANCHO NM
87124-4741
US

IV. Provider business mailing address

PO BOX 26666 PHS PROVIDER ENROLLMENT
ALBUQUERQUE NM
87125-6666
US

V. Phone/Fax

Practice location:
  • Phone: 505-253-3000
  • Fax: 505-253-3001
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD20231176
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: