Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | RF041043 | MI |
Y | 207YP0228X | Pediatric Otolaryngology | RF041043 | MI |
NPI | 1881786341 |
---|---|
Provider Name | Dr. Robert A Fishman |
First Address | St Clair Shores, MI 48081 |
Second Address | Saint Clair Shores, MI 48081-1116 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2006 |
Last Update Date | 22/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
040008563 | RAILROAD MEDICARE (01) | |
040E06192 | BLUE SHIELD GROUP (01) | MI |
0500323 | BLUE CARE NETWORK (01) | |
101764 | CARE CHOICES (01) | |
103994 | GREAT LAKES HEALTH (01) | |
1433910 | (05) | MI |
2326702002 | CIGNA (01) | |
44033233 | AETNA (01) | |
C5083 | MCAR (01) | |
D91373 | (02) | MI |
D91373 | HEALTH ALLIANCE PLAN (01) |