Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | MD 2014-0017 | NM |
Y | 207XS0117X | Orthopaedic Spine Surgeon | MD 2014-0017 | NM |
NPI | 1295002780 |
---|---|
Provider Name | Urvij Mahendrakumar Modhia |
First Address | Albuquerque, NM 87106-4374 |
Second Address | Albuquerque, NM 87131-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/11/2011 |
Last Update Date | 05/09/2014 |