Individual
ROBERT VITEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5901 HARPER DR NE, ALBUQUERQUE, NM 87109-3587
(505) 823-8450
(505) 823-8484
Mailing address
PO BOX 26666, PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-5356
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
Primary
93-419
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
NM
Enumeration date
04/23/2007
Last updated
07/08/2007
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