Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | BP20032170 | TX |
N | 208600000X | Surgeon | BP20032170 | TX |
Y | 2086S0122X | Plastic and Reconstructive Surgery | MD-41973 | IA |
N | 2086S0122X | Plastic and Reconstructive Surgery | MD449430 | PA |
NPI | 1174623227 |
---|---|
Provider Name | Dr. Mark Daniel Fisher |
First Address | Iowa City, IA 52242-1009 |
Second Address | Iowa City, IA 52242-1009 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2006 |
Last Update Date | 11/08/2014 |