Provider Demographics
NPI:1679525059
Name:FISHER, MICHAEL JOSEPH (MD, FACG)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JOSEPH
Last Name:FISHER
Suffix:
Gender:M
Credentials:MD, FACG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 IDLEWILD AVE
Mailing Address - Street 2:DIGESTIVE HEALTH ASSOCIATES, PA
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-3825
Mailing Address - Country:US
Mailing Address - Phone:410-822-6005
Mailing Address - Fax:410-822-9253
Practice Address - Street 1:511 IDLEWILD AVE
Practice Address - Street 2:DIGESTIVE HEALTH ASSOCIATES, PA
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-3825
Practice Address - Country:US
Practice Address - Phone:410-822-6005
Practice Address - Fax:410-822-9253
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0031867207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1679525059Medicaid
MD1679525059Medicaid
MDKK37Medicare ID - Type Unspecified