Provider Demographics
NPI:1306852025
Name:FISHER, CHRISTEN J (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTEN
Middle Name:J
Last Name:FISHER
Suffix:
Gender:F
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:PO BOX 470408
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28247-0408
Mailing Address - Country:US
Mailing Address - Phone:704-375-0100
Mailing Address - Fax:704-375-8623
Practice Address - Street 1:7845 LITTLE AVE
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-8198
Practice Address - Country:US
Practice Address - Phone:704-375-0100
Practice Address - Fax:704-375-8623
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2018-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2006-00932207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
201089OtherMEDCOST
NC5907354Medicaid
1432FOtherBCBS
9084107OtherAETNA
SCQ0093CMedicaid
NC1306852025OtherBCBS
NC1306852025Medicaid
VA1306852025Medicaid
WV3810009742Medicaid
810611OtherPARTNERS
WV3810009742Medicaid