Provider Demographics
NPI:1356569867
Name:RITSEMA, MOLLY ELIZABETH (MD)
Entity type:Individual
Prefix:DR
First Name:MOLLY
Middle Name:ELIZABETH
Last Name:RITSEMA
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Gender:F
Credentials:MD
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Mailing Address - Street 1:8801 HORIZON BLVD NE
Mailing Address - Street 2:SUITE 360
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87113-1533
Mailing Address - Country:US
Mailing Address - Phone:505-828-4923
Mailing Address - Fax:505-213-0103
Practice Address - Street 1:5757 HARPER DR NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-3566
Practice Address - Country:US
Practice Address - Phone:505-888-5757
Practice Address - Fax:505-889-3589
Is Sole Proprietor?:No
Enumeration Date:2007-04-22
Last Update Date:2008-04-25
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Provider Licenses
StateLicense IDTaxonomies
NMMD2007-0475207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMP00426458OtherRRB MEDICARE RAILROAD
AZ237929Medicaid
NM96634774Medicaid
NMNM001A78OtherBC BS OF NM