Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 01036160A | IN |
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 01036160A | IN |
NPI | 1437152469 |
---|---|
Provider Name | Steven E Fisher |
First Address | Fort Wayne, IN 46801-2526 |
Second Address | Fort Wayne, IN 46804-4133 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2005 |
Last Update Date | 07/11/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00000089399 | ANTHEM (01) | |
100340120A | (05) | IN |
200015793 | RAILROAD MEDICARE (01) | |
E81796 | (02) | IN |