Fisherkeller, Mark

Fisherkeller, Mark is an individual health care provider with primary practice located at 90 Quarry St , Willimantic CT 06226-1225. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Nuclear Cardiology, Allopathic & Osteopathic Physicians / Cardiovascular Disease. Allopathic & Osteopathic Physicians / Cardiovascular Disease is his primary health care specialty. Fisherkeller, Mark can be contacted via phone (860) 456-2898.

Contact Information

Primary practice address
90 Quarry St Willimantic CT 06226-1225
Phone: (860) 456-2898
Fax: (860) 456-3078
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nuclear Cardiology 207UN0901X 021796 Connecticut
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 021796 Connecticut

Profile Details

NPI number 1629026380
LBN Legal business name Fisherkeller, Mark
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 5th, 2006
Last updated May 4th, 2012 - about 14 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629026380 NPPES
Connecticut MEDICAID 001217967

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