Provider Demographics
NPI:1013577121
Name:FISCHER, MICAH A (DO)
Entity Type:Individual
Prefix:DR
First Name:MICAH
Middle Name:A
Last Name:FISCHER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 S PINE ST, JMB, 2ND FLOOR
Mailing Address - Street 2:
Mailing Address - City:SEYMOUR
Mailing Address - State:IN
Mailing Address - Zip Code:47274
Mailing Address - Country:US
Mailing Address - Phone:812-524-4265
Mailing Address - Fax:812-524-4269
Practice Address - Street 1:225 S PINE ST, JMB, 2ND FLOOR
Practice Address - Street 2:
Practice Address - City:SEYMOUR
Practice Address - State:IN
Practice Address - Zip Code:47274
Practice Address - Country:US
Practice Address - Phone:812-524-4265
Practice Address - Fax:812-524-4269
Is Sole Proprietor?:No
Enumeration Date:2019-06-20
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02007129A207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics