Provider Demographics
NPI:1437136298
Name:FISHER, ANDREW J (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:J
Last Name:FISHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10800 E GEDDES AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80112-3895
Mailing Address - Country:US
Mailing Address - Phone:303-761-9190
Mailing Address - Fax:720-874-4462
Practice Address - Street 1:501 E HAMPDEN AVE
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2702
Practice Address - Country:US
Practice Address - Phone:303-761-9190
Practice Address - Fax:720-874-4462
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD174772085R0202X
KS04-363282085R0202X
NE249732085R0202X
CO375492085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY118175100Medicaid
MT1437136298Medicaid
CA1437136298Medicaid
WA2009518Medicaid
NE84-059792913Medicaid
AL009981175Medicaid
NE10025709000Medicaid
MI104686113Medicaid
CO99453797Medicaid
AKMD754COMedicaid
KS200418420AMedicaid
TX074088802Medicaid
SD1437136298/7729282Medicaid
MO1437136298Medicaid
IA0749705Medicaid
SD1437136298Medicaid
UT1679513196Medicaid
OK200236540AMedicaid
AZ922329Medicaid
HI0000341420OtherHMSA ALL PRODUCTS
NC7617667Medicaid
CA1437136298Medicaid
COG29230Medicare UPIN
SD1437136298/7729282Medicaid
WY118175100Medicaid
IA0749705Medicaid
UT1679513196Medicaid
OK200236540AMedicaid
IL$$$$$$$$$Medicaid
AZ922329Medicaid
NENA1215003Medicare PIN
CO300127441Medicare PIN
HIH105020Medicare PIN
KSKA3249046Medicare PIN
MI104686113Medicaid
NE84-059792913Medicaid
AKMD754COMedicaid
WA2009518Medicaid