Provider Demographics
NPI:1558476366
Name:FISCHER, ALFRED (DC)
Entity Type:Individual
Prefix:DR
First Name:ALFRED
Middle Name:
Last Name:FISCHER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1190 JEFFERSON ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:WASHINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:63090-4443
Mailing Address - Country:US
Mailing Address - Phone:636-239-3265
Mailing Address - Fax:636-239-5385
Practice Address - Street 1:1190 JEFFERSON ST
Practice Address - Street 2:SUITE 203
Practice Address - City:WASHINGTON
Practice Address - State:MO
Practice Address - Zip Code:63090-4443
Practice Address - Country:US
Practice Address - Phone:636-239-3265
Practice Address - Fax:636-239-5385
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2011-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO004925111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO26408OtherGROUP HEALTH PLAN
MO238035OtherHEALTHLINK
MO309002OtherAETNA
MO4400439OtherUNITED HEALTH CARE
MO6296OtherBLUE CROSS BLUE SHIELD
MO6296OtherBLUE CROSS BLUE SHIELD
MOT43480Medicare UPIN