Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 34.013781 | OH |
NPI | 1003231853 |
---|---|
Provider Name | Nathan M Fisher |
First Address | Saint Louis, MO 63128-2786 |
Second Address | Saint Louis, MO 63128-2786 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/03/2014 |
Last Update Date | 22/12/2021 |