Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | OS8809 | FL |
NPI | 1164454625 |
---|---|
Provider Name | Dr. Herbert Maurice Fichman |
First Address | Lake Worth, FL 33467-6930 |
Second Address | Delray Beach, FL 33445-4616 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2006 |
Last Update Date | 14/12/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
16386 | BLUE CROSS/BLUE SHIELD (01) | FL |
2713331-00 | (05) | FL |
E76766 | (02) | FL |
U39737 | (02) |