Provider Demographics
NPI:1346235231
Name:FISHER, DENNIS F (PHD)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:F
Last Name:FISHER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2832C CHURCHVILLE RD
Mailing Address - Street 2:
Mailing Address - City:CHURCHVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21028-1620
Mailing Address - Country:US
Mailing Address - Phone:410-836-7222
Mailing Address - Fax:410-836-2793
Practice Address - Street 1:2832C CHURCHVILLE RD
Practice Address - Street 2:
Practice Address - City:CHURCHVILLE
Practice Address - State:MD
Practice Address - Zip Code:21028-1620
Practice Address - Country:US
Practice Address - Phone:410-836-7222
Practice Address - Fax:410-836-2793
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-16
Last Update Date:2007-11-16
Deactivation Date:2006-03-23
Deactivation Code:
Reactivation Date:2006-03-28
Provider Licenses
StateLicense IDTaxonomies
MD953103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDR09273Medicare PIN
MDR09273Medicare ID - Type UnspecifiedMEDICARE