Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | MD473626 | PA |
NPI | 1033649033 |
---|---|
Provider Name | Dr. Renae R Fisher |
First Address | Philadelphia, PA 19107 |
Second Address | Philadelphia, PA 19107 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2017 |
Last Update Date | 28/07/2021 |