Provider Demographics
NPI:1710084520
Name:FITCH, ERNESTINE LOUISE (MD)
Entity Type:Individual
Prefix:DR
First Name:ERNESTINE
Middle Name:LOUISE
Last Name:FITCH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4859 DOVER CENTER RD
Mailing Address - Street 2:SUITE 10
Mailing Address - City:NORTH OLMSTED
Mailing Address - State:OH
Mailing Address - Zip Code:44070-3184
Mailing Address - Country:US
Mailing Address - Phone:440-979-1224
Mailing Address - Fax:440-979-9730
Practice Address - Street 1:4859 DOVER CENTER RD
Practice Address - Street 2:SUITE 10
Practice Address - City:NORTH OLMSTED
Practice Address - State:OH
Practice Address - Zip Code:44070-3184
Practice Address - Country:US
Practice Address - Phone:440-979-1224
Practice Address - Fax:440-979-9730
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35049701207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine