1811127780 NPI number — DR. RACHEL CARYN FISCHER MD

Table of content: DR. RACHEL CARYN FISCHER MD (NPI 1811127780)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811127780 NPI number — DR. RACHEL CARYN FISCHER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FISCHER
Provider First Name:
RACHEL
Provider Middle Name:
CARYN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

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:
1811127780
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/20/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3553 CLYDESDALE PKWY
Provider Second Line Business Mailing Address:
SUITE 230
Provider Business Mailing Address City Name:
LOVELAND
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80538
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
970-278-0900
Provider Business Mailing Address Fax Number:
970-278-4005

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3553 CLYDESDALE PKWY
Provider Second Line Business Practice Location Address:
SUITE 230
Provider Business Practice Location Address City Name:
LOVELAND
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80538
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
970-278-0900
Provider Business Practice Location Address Fax Number:
970-278-4005
Provider Enumeration Date:
07/24/2009

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: 2083P0500X , with the licence number:  MD153557 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2083P0500X , with the licence number: 0059225 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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