Provider Demographics
NPI:1316086309
Name:PAI, HEMANTH K (MD)
Entity type:Individual
Prefix:
First Name:HEMANTH
Middle Name:K
Last Name:PAI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:500 WALTER ST NE STE 110
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87102-2541
Mailing Address - Country:US
Mailing Address - Phone:505-727-8360
Mailing Address - Fax:505-727-8678
Practice Address - Street 1:601 DR MARTIN LUTHER KING JR AVE NE STE 110
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-3619
Practice Address - Country:US
Practice Address - Phone:505-727-8360
Practice Address - Fax:505-727-8678
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2024-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2007-0673207RE0101X, 208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM58537741Medicaid
342803201Medicare PIN