Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207K00000X | Allergist & Immunologist | CS8800492 | DC |
Y | 207KA0200X | Allergist | MD12429 | DC |
NPI | 1295899979 |
---|---|
Provider Name | Dr. Henry James Fishman |
First Address | Washington, DC 20006-1017 |
Second Address | Washington, DC 20006-1017 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/12/2006 |
Last Update Date | 31/07/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1922409705 | MEDICARE GROUP NPI (01) | DC |
D09371 | (02) | DC |