Fisher, Edward J.

Fisher, Edward J. is an individual health care provider with primary practice located at 12720 Bass Lake Rd , Maple Grove MN 55369-6307. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Fisher, Edward J. can be contacted via phone (763) 559-2861.

Contact Information

Primary practice address
12720 Bass Lake Rd Maple Grove MN 55369-6307
Fax: (763) 559-1338
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 25642 Minnesota

Profile Details

NPI number 1740257187
LBN Legal business name Fisher, Edward J.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 3rd, 2006
Last updated Sep 22nd, 2011 - about 13 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 1740257187 NPPES
Minnesota MEDICAID 435800700

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