Provider Demographics
NPI:1225037161
Name:FISHER, MICHAEL SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:SCOTT
Last Name:FISHER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1265 UPPER HEMBREE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-1143
Mailing Address - Country:US
Mailing Address - Phone:770-751-1133
Mailing Address - Fax:770-751-7410
Practice Address - Street 1:1265 UPPER HEMBREE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-1143
Practice Address - Country:US
Practice Address - Phone:770-751-1133
Practice Address - Fax:770-751-7410
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2013-10-24
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Provider Licenses
StateLicense IDTaxonomies
GA034135207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA07BDCLBMedicare ID - Type Unspecified
GAF43139Medicare UPIN