Provider Demographics
NPI:1215214143
Name:FISCHER, DANIEL JOSEPH (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:JOSEPH
Last Name:FISCHER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5145 GEORGINE DR
Mailing Address - Street 2:
Mailing Address - City:IMPERIAL
Mailing Address - State:MO
Mailing Address - Zip Code:63052-4029
Mailing Address - Country:US
Mailing Address - Phone:314-835-7893
Mailing Address - Fax:
Practice Address - Street 1:1718 CATLIN DR
Practice Address - Street 2:
Practice Address - City:BARNHART
Practice Address - State:MO
Practice Address - Zip Code:63012-1277
Practice Address - Country:US
Practice Address - Phone:636-461-6030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-06
Last Update Date:2011-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007026608183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist