person
Mohan Kumar Bangalore Puttaiah, MD
Family Medicine Physician in Lovington, New Mexico
NPI 1619007697

Mohan Kumar Bangalore Puttaiah is a Family Medicine Physician based in Lovington, NM. Mohan Kumar Bangalore Puttaiah practices in Lovington, NM and has the professional credentials of MD. The NPI Number for Mohan Kumar Bangalore Puttaiah is 1619007697 and holds a License No. M-8828 (New Mexico).

The current practice location address for Mohan Kumar Bangalore Puttaiah is 1600 N Main Ave, Lovington, NM and can be reached out via phone at 575-396-6611.

Location: 1600 N Main Ave, Lovington, NM, 88260-2830
person
Provider Profile Details
NPI Number
1619007697
Provider Name
Mohan Kumar Bangalore Puttaiah
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
1600 N Main Ave, Lovington, NM, 88260-2830
Phone Number
575-396-6611
Fax Number
Provider Enumeration Date
03/07/2007
Last Update Date
12/14/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
0-569-979-8 01 ID ECFMG CERTIFICATION #
00010145533 01 ID BLUESHIELD OF IDAHO GF #
000010145534 01 ID BLUESHIELD OF IDAHO MH #
000010145537 01 ID BLUESHIELD OF IDAHO GV #
58826 01 ID BLUE CROSS OF IDAHO
539004052 08 01 ID I-94 # CLASS H1B1
806780500 05 ID
0007241559 01 ID AETNA ID #
284867 01 ID ALTIUS HEALTH PLAN BILL #
CS10257 01 ID IDAHO CONTROLLED SUBST. #
M-8828 01 ID IDAHO MEDICAL LICENSE #
P00161243 01 ID RAILROAD MEDICARE BILL #
institution
Provider Business Practice Location Address Details
Address
1600 N Main Ave
City
State
Zip
88260-2830
Phone Number
575-396-6611
Fax Number
person
Provider Business Mailing Address Details
Address
1600 N Main Ave
City
State
Zip
88260-2830
Phone Number
575-396-6611
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Family Medicine
Speciality
-
Taxonomy
License No.
M-8828 (Idaho)
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
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