DR. CLEORA SHUNKAMOLAH M.D. NPI 1073581583

NPI Information

NPI: 1073581583
Provider Name: DR. CLEORA SHUNKAMOLAH, M.D.
Classification: General Practice - 208D00000X
Entity Type: Individual
Organization: DHHS PHS NAIHS GALLUP INDIAN MEDICAL CENTER

PECOS Registration: Yes

Address:
516 E NIZHONI BLVD
GALLUP, NM
ZIP 87301
Phone: (505) 722-1000
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DR. Cleora Shunkamolah, M.D. is a general practice in Gallup, NM with 37 years of experience. DR. Cleora Shunkamolah, M.D. NPI is 1073581583. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: UNIVERSITY OF NEW MEXICO SCHOOL OF MEDICINE
Graduation Year:1987

The provider's business location address is:

516 E NIZHONI BLVD
GALLUP, NM
ZIP 87301-748
Phone: (505) 722-1000

The NPI 1073581583 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/9/2006 and was last updated on 12/29/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208D00000X	General Practice		89-303	NEW MEXICO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	E62050	MEDICARE UPIN	NEW MEXICO
2	419475	MEDICAID	ARIZONA
3	8HC734	MEDICARE ID-TYPE UNSPECIFIED	NEW MEXICO
4	R7335	MEDICAID	NEW MEXICO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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