Individual
PATRICIA M FITCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
806 DR MARTIN LUTHER KING JR AVE NE, ALBUQUERQUE, NM 87102-3657
(505) 842-6575
(505) 213-0103
Mailing address
8801 HORIZON BLVD NE, SUITE 360, ALBUQUERQUE, NM 87113-1533
(505) 828-4923
(505) 213-0103
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
329
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
483665YTQZ
MEDICARE PTAN
NM
05
—
P0847
—
NM
Enumeration date
07/11/2006
Last updated
07/25/2023
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