Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 87-233 | NM |
NPI | 1063473403 |
---|---|
Provider Name | Dr. Heidi Elizabeth Fleischmann |
First Address | Albuquerque, NM 87109-1533 |
Second Address | Albuquerque, NM 87109-1533 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2006 |
Last Update Date | 28/11/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A51316 | (02) | NM |