Fisher, Mark A

Fisher, Mark A is an individual health care provider with primary practice located at 1721 Magnavox Way , Fort Wayne IN 46804-1537. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Fisher, Mark A can be contacted via phone (260) 748-3650.

Contact Information

Primary practice address
1721 Magnavox Way Fort Wayne IN 46804-1537
Phone: (260) 748-3650
Fax: (360) 748-3651
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 10000311A Indiana

Profile Details

NPI number 1144215153
LBN Legal business name Fisher, Mark A
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 15th, 2005
Last updated Feb 4th, 2019 - about 5 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 1144215153 NPPES
Indiana MEDICAID 300006102
Indiana Other 931711

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