Provider Demographics
NPI:1497749865
Name:FISHER, MARGARET E P (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:E P
Last Name:FISHER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:MARGARET
Other - Middle Name:ELLEN
Other - Last Name:POLIFKO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:9225 DOERR RD BLDG 1220
Mailing Address - Street 2:
Mailing Address - City:FORT BELVOIR
Mailing Address - State:VA
Mailing Address - Zip Code:22060-2204
Mailing Address - Country:US
Mailing Address - Phone:571-231-6005
Mailing Address - Fax:
Practice Address - Street 1:9225 DOERR RD BLDG 1220
Practice Address - Street 2:
Practice Address - City:FORT BELVOIR
Practice Address - State:VA
Practice Address - Zip Code:22060-2204
Practice Address - Country:US
Practice Address - Phone:571-231-6005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401411056122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice