Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 50819 | MN |
N | 208600000X | Surgeon | 50819 | MN |
Y | 2086S0120X | Pediatric Surgery | 50819 | MN |
N | 2086S0120X | Pediatric Surgery | Q9609 | TX |
NPI | 1134327901 |
---|---|
Provider Name | James E Fisher |
First Address | Minneapolis, MN 55404-4293 |
Second Address | Minneapolis, MN 55404-4293 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2007 |
Last Update Date | 05/12/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P01149707 | RAILROAD MEDICARE (01) | MN |