Provider Demographics
NPI:1033139662
Name:FISHER, QUENTIN A (MD)
Entity Type:Individual
Prefix:
First Name:QUENTIN
Middle Name:A
Last Name:FISHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6213 STONEHAM RD
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-1758
Mailing Address - Country:US
Mailing Address - Phone:301-530-0125
Mailing Address - Fax:
Practice Address - Street 1:6213 STONEHAM RD
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-1758
Practice Address - Country:US
Practice Address - Phone:301-530-0125
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD32424207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010162297Medicaid
DC210082OtherKAISER
DC0166OtherCAREFIRST BCBS
DC3965073OtherAETNA HMO
DC4647273OtherAETNA NON HMO
DC500368OtherNCPPO
VA180608OtherANTHEM BCBS
DC020533700Medicaid
MD337701601Medicaid
DC4647273OtherAETNA NON HMO
DC3965073OtherAETNA HMO
VA180608OtherANTHEM BCBS