Provider Demographics
NPI:1669648101
Name:FISHER, JESSICA MEGAN (MD)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:MEGAN
Last Name:FISHER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:191 BILTMORE AVE
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-4109
Mailing Address - Country:US
Mailing Address - Phone:828-254-0881
Mailing Address - Fax:828-254-1614
Practice Address - Street 1:191 BILTMORE AVE
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4109
Practice Address - Country:US
Practice Address - Phone:828-254-0881
Practice Address - Fax:828-254-1614
Is Sole Proprietor?:No
Enumeration Date:2008-05-05
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2015-01488207RG0100X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1669648101Medicaid
NC19DS5OtherBCBS OF NORTH CAROLINA
NC19DS5OtherBCBS OF NORTH CAROLINA