Individual
DR. MICHAEL GLEN FITZGERALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
520 E 6TH ST, ODESSA, TX 79761-4527
(800) 967-2289
(855) 462-9736
Mailing address
777 LOWNDES HILL RD BLDG 1, GREENVILLE, SC 29607-2101
(800) 967-2289
(855) 462-9736
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
4644
AK
207V00000X
Obstetrics & Gynecology Physician
Primary
G5044
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MD67611
—
AK
Enumeration date
08/11/2005
Last updated
10/03/2022
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