Healthcare Provider Details

I. General information

NPI: 1063473403
Provider Name (Legal Business Name): HEIDI ELIZABETH FLEISCHMANN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/28/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7520 MONTGOMERY BLVD NE BLDG D4
ALBUQUERQUE NM
87109-1533
US

IV. Provider business mailing address

7520 MONTGOMERY BLVD NE BLDG D4
ALBUQUERQUE NM
87109-1533
US

V. Phone/Fax

Practice location:
  • Phone: 505-884-7070
  • Fax: 505-884-6018
Mailing address:
  • Phone: 505-884-7070
  • Fax: 505-884-6018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number87-233
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: