Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 6467 | AK |
Y | 207QG0300X | Family Doctor - Geriatric Medicine | 201500226 | NC |
N | 207QG0300X | Family Doctor - Geriatric Medicine | 348 | SC |
NPI | 1003834136 |
---|---|
Provider Name | Dr. Timothy Lee Fischer |
First Address | Winston Salem, NC 27106-3410 |
Second Address | Winston Salem, NC 27106-3410 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 13/07/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
003481 | (05) | SC |
E43099 | (02) | SC |