Healthcare Provider Details

I. General information

NPI: 1316045495
Provider Name (Legal Business Name): ELIZABETH BATCHER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 11/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4060 DIETZ FARM CIR NW
LOS RANCHOS NM
87107-3104
US

IV. Provider business mailing address

4060 DIETZ FARM CIRCLE NW
ALBUQUERQUE NM
87107
US

V. Phone/Fax

Practice location:
  • Phone: 505-250-2612
  • Fax:
Mailing address:
  • Phone: 505-250-2612
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberA76468
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: