Provider Demographics
NPI:1649230293
Name:FISCHMAN, DAVID MARC (DPM)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MARC
Last Name:FISCHMAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 W INDIANTOWN RD
Mailing Address - Street 2:SUITE 15
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-6811
Mailing Address - Country:US
Mailing Address - Phone:561-575-2266
Mailing Address - Fax:561-745-8510
Practice Address - Street 1:901 W INDIANTOWN RD
Practice Address - Street 2:SUITE 15
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-6811
Practice Address - Country:US
Practice Address - Phone:561-575-2266
Practice Address - Fax:561-745-8510
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLP00002046213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
65160ZMedicare ID - Type Unspecified
U12134Medicare UPIN