Provider Demographics
NPI:1275701195
Name:FISCHER, MARTA LOUISE (DO)
Entity Type:Individual
Prefix:
First Name:MARTA
Middle Name:LOUISE
Last Name:FISCHER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:MARTA
Other - Middle Name:LOUISE
Other - Last Name:GREER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:401 E 20TH ST
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:41014-1583
Mailing Address - Country:US
Mailing Address - Phone:859-655-7160
Mailing Address - Fax:859-655-6742
Practice Address - Street 1:747 BUTTERMILK PIKE
Practice Address - Street 2:
Practice Address - City:CRESCENT SPRINGS
Practice Address - State:KY
Practice Address - Zip Code:41017-1303
Practice Address - Country:US
Practice Address - Phone:859-341-3114
Practice Address - Fax:859-578-2156
Is Sole Proprietor?:No
Enumeration Date:2008-02-13
Last Update Date:2009-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY03067207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100047200Medicaid
KY0200821Medicare PIN
KY0364986Medicare PIN
P00668100Medicare PIN