Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 01024637A | IN |
NPI | 1053389379 |
---|---|
Provider Name | William B Fisher |
First Address | Muncie, IN 47303-4609 |
Second Address | Muncie, IN 47303-3428 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/03/2006 |
Last Update Date | 04/05/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100105020 | (05) | IN |
C24604 | (02) | IN |
P01014246 | RR MEDICARE (01) | IN |