Provider Demographics
NPI:1073050175
Name:FISHER, THOMAS A (BC ACA)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:A
Last Name:FISHER
Suffix:
Gender:M
Credentials:BC ACA
Other - Prefix:
Other - First Name:THOMAS
Other - Middle Name:A
Other - Last Name:FISHER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BC ACA
Mailing Address - Street 1:2701 BEL AIR RD
Mailing Address - Street 2:
Mailing Address - City:FALLSTON
Mailing Address - State:MD
Mailing Address - Zip Code:21047-2871
Mailing Address - Country:US
Mailing Address - Phone:410-838-2800
Mailing Address - Fax:410-877-7087
Practice Address - Street 1:2701 BEL AIR RD
Practice Address - Street 2:
Practice Address - City:FALLSTON
Practice Address - State:MD
Practice Address - Zip Code:21047-2871
Practice Address - Country:US
Practice Address - Phone:410-838-2800
Practice Address - Fax:410-877-7087
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-26
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01289237700000X
DE03-0000030237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD237700000XOtherHEARING INSTRUMENT SPECIALIST