Individual
CASSIE FAIRCHILD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
SOUTH VALLEY HEALTH CENTER, 2001 CENTROL FAMILIAR SW, ALBUQUERQUE, NM 87105-4592
(505) 873-7400
Mailing address
PO BOX 912678, DENVER, CO 80291-2678
(505) 241-5182
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD2017-0762
NM
390200000X
Student in an Organized Health Care Education/Training Program
RS2014-0350
NM
Other
Enumeration date
04/29/2014
Last updated
10/17/2024
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