Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | ME80444 | FL |
N | 111NI0900X | Internist | ME80444 | FL |
N | 207RC0001X | Clinical Cardiac Electrophysiologist | MD61116789 | WA |
Y | 2080P0202X | Pediatric Cardiologist | MD61116789 | WA |
N | 2080P0202X | Pediatric Cardiologist | ME80444 | FL |
NPI | 1225002587 |
---|---|
Provider Name | Dr. Steven Bruce Fishberger |
First Address | Liberty Lake, WA 99019-0421 |
Second Address | Spokane, WA 99204-2307 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2006 |
Last Update Date | 26/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
259030100 | (05) | FL |
K7151 | (02) | FL |