Fisher, Mark A
Fisher, Mark A is an individual health care provider with primary practice located at 1721 Magnavox Way , Fort Wayne IN 46804-1537. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Fisher, Mark A can be contacted via phone (260) 748-3650.Contact Information
Primary practice address
1721 Magnavox Way
Fort Wayne IN 46804-1537
Phone: (260) 748-3650
Fax: (360) 748-3651
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 10000311A | Indiana |
Profile Details
| NPI number | 1144215153 |
|---|---|
| LBN Legal business name | Fisher, Mark A |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 15th, 2005 |
| Last updated | Feb 4th, 2019 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1144215153 | NPPES |
| Indiana | MEDICAID | 300006102 | |
| Indiana | Other | 931711 |
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