1770542391 NPI number — DAVID CHRISTOPHER FISHER MD

Table of content: (NPI 1982237681)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770542391 NPI number — DAVID CHRISTOPHER FISHER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FISHER
Provider First Name:
DAVID
Provider Middle Name:
CHRISTOPHER
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1770542391
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
44 BINNEY ST
Provider Second Line Business Mailing Address:
D1830
Provider Business Mailing Address City Name:
BOSTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02115
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
617-632-6844
Provider Business Mailing Address Fax Number:
617-632-4422

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
44 BINNEY ST
Provider Second Line Business Practice Location Address:
D1830
Provider Business Practice Location Address City Name:
BOSTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02115
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-632-6844
Provider Business Practice Location Address Fax Number:
617-632-4422
Provider Enumeration Date:
03/22/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RH0003X , with the licence number:  80650 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 759412 . This is a "TUFTS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3600190 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 8834749 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 40304 . This is a "FALLON COMMUNITY HEALTH P" identifier . This identifiers is of the category "OTHER".
  • Identifier: G13811DF . This is a "HPHC (DFCI ONLY)" identifier . This identifiers is of the category "OTHER".
  • Identifier: J31627 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0607808 . This is a "AETNA US HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3146197 . This is a "MASSHEALTH (MA MEDICAID)" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com