Organization
EVOLVE ABQ PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LIDA FATEMI DO (PRACTITIONER)
(404) 272-6088
Entity
Organization
Contact information
Practice address
4550 EUBANK BLVD NE STE 107, ALBUQUERQUE, NM 87111-2565
(505) 616-0915
Mailing address
4550 EUBANK BLVD NE STE 108, ALBUQUERQUE, NM 87111-2565
(505) 485-2545
(505) 657-7309
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
07/18/2025
Last updated
02/04/2026
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