Healthcare Provider Details

I. General information

NPI: 1497761910
Provider Name (Legal Business Name): CHRISTOPHER RICHARD FLETCHER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: SANTA FE FAMILY PRACTICE

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 04/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2015 GALISTEO ST
SANTA FE NM
87505-2101
US

IV. Provider business mailing address

2015 GALISTEO ST
SANTA FE NM
87505-2101
US

V. Phone/Fax

Practice location:
  • Phone: 505-989-9144
  • Fax: 505-989-1550
Mailing address:
  • Phone: 505-989-9144
  • Fax: 505-989-1550

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number81-45
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: