Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | 18809 | MN |
NPI | 1780781021 |
---|---|
Provider Name | Alfred J Fish |
First Address | Minneapolis, MN 55455 |
Second Address | Minneapolis, MN 55455 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0052088 | (05) | MT |
050401 | FAIRVIEW (01) | MN |
0990382 | (05) | IA |
1010277 | PREFERRED ONE (01) | MN |
101070 | UCARE (01) | MN |
2T277FI | BCBS (01) | MN |
31-22593 | MEDICA-CHOICE (01) | MN |
3174530 | MEDICA-PRIMARY (01) | MN |
768114 | ARAZ (01) | |
D81974 | (02) | |
HP13287 | HEALTH PARTNERS (01) | MN |