Provider Demographics
NPI:1437291820
Name:FISCHER, STEVEN CHARLES (PHD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:CHARLES
Last Name:FISCHER
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 1:32905 W 12 MILE RD
Mailing Address - Street 2:SUITE 440
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-3342
Mailing Address - Country:US
Mailing Address - Phone:248-626-7082
Mailing Address - Fax:248-737-6091
Practice Address - Street 1:32905 W 12 MILE RD
Practice Address - Street 2:SUITE 440
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-3342
Practice Address - Country:US
Practice Address - Phone:248-626-7082
Practice Address - Fax:248-737-6091
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2011-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301005339103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIR67169Medicare UPIN
MI0N10260Medicare ID - Type Unspecified