Individual
EDWIN HATCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
201 CEDAR ST SE STE 503, PMG CEDAR PEDIATRIC SURGERY, ALBUQUERQUE, NM 87106-4925
(505) 224-7478
(505) 224-7479
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-5356
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
2001210
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
G5526
—
NM
Enumeration date
10/03/2006
Last updated
07/17/2008
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