Fitzgerald, Michael Glen

Fitzgerald, Michael Glen is an sole proprietor health care provider with primary practice located at 520 E 6Th St , Odessa TX 79761-4527. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Obstetrics & Gynecology. Allopathic & Osteopathic Physicians / Obstetrics & Gynecology is his primary health care specialty. Fitzgerald, Michael Glen can be contacted via phone (800) 967-2289.

Contact Information

Primary practice address
520 E 6Th St Odessa TX 79761-4527
Phone: (800) 967-2289
Fax: (855) 462-9736
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 4644 Alaska
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X G5044 Texas

Profile Details

NPI number 1831191527
LBN Legal business name Fitzgerald, Michael Glen
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 11th, 2005
Last updated Oct 3rd, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1831191527 NPPES
Alaska MEDICAID MD67611

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