Provider Demographics
NPI:1598105207
Name:FISCHER, SAMANTHA (PA-C)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:FISCHER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 ELKRIDGE LANDING RD FL 2
Mailing Address - Street 2:
Mailing Address - City:LINTHICUM
Mailing Address - State:MD
Mailing Address - Zip Code:21090-2924
Mailing Address - Country:US
Mailing Address - Phone:443-462-5010
Mailing Address - Fax:
Practice Address - Street 1:7501 OSLER DR STE 205
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-7743
Practice Address - Country:US
Practice Address - Phone:410-427-5510
Practice Address - Fax:410-427-5511
Is Sole Proprietor?:No
Enumeration Date:2013-06-26
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA23191363AM0700X
NJ25MP00301200363AM0700X
PAMA055711363AM0700X
NVPA 1434363AM0700X
MDC07082363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical