Provider Demographics
NPI:1679592984
Name:FISHER, STEVEN A (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:A
Last Name:FISHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:15 CORPORATE DR
Mailing Address - Street 2:SUITE 2-1
Mailing Address - City:TRUMBULL
Mailing Address - State:CT
Mailing Address - Zip Code:06611-1351
Mailing Address - Country:US
Mailing Address - Phone:203-452-2446
Mailing Address - Fax:203-452-2424
Practice Address - Street 1:15 CORPORATE DR
Practice Address - Street 2:SUITE 2-1
Practice Address - City:TRUMBULL
Practice Address - State:CT
Practice Address - Zip Code:06611-1351
Practice Address - Country:US
Practice Address - Phone:203-452-2446
Practice Address - Fax:203-452-2424
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT028987207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT010028987CT03OtherANTHEM BLUE CROSS BLUE SH
CTCU8816OtherHEALTHNET
CTZP326OtherOXFORD HEALTH PLANS
CT484982OtherAETNA
CT528987OtherCONNECTICARE, INC & AFFIL
CT0649810OtherCIGNA HEALTHCARE OF CT
CT010028987CT03OtherANTHEM BLUE CROSS BLUE SH