Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0208X | Pediatric Infectious Diseases | DR.0044844 | CO |
NPI | 1477095958 |
---|---|
Provider Name | Marc Fischer |
First Address | Fort Collins, CO 80521 |
Second Address | Fort Collins, CO 80521-3003 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2016 |
Last Update Date | 15/11/2016 |