Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 34325-020 | WI |
Y | 111NI0900X | Internist | 34325-020 | WI |
N | 207RA0201X | Internist - Allergy & Immunology | 34325-020 | WI |
NPI | 1841214061 |
---|---|
Provider Name | Robert H Fisher |
First Address | Glendale, WI 53217-3815 |
Second Address | Glendale, WI 53217 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 24/11/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0557326 | CIGNA (01) | |
31925700 | (05) | WI |
392032824 | WEA (01) | |
3920328241071690 | UNITED HEALTHCARE (01) | |
4638942 | AETNA (01) | |
C83791 | (02) | |
P00308927 | MEDICARE RAILROAD (01) | WI |