Provider Demographics
NPI:1679763882
Name:FISHER, ERICA JOY (DO)
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:JOY
Last Name:FISHER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:MS
Other - First Name:ERICA
Other - Middle Name:JOY
Other - Last Name:TULL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO,
Mailing Address - Street 1:50 N PERRY ST
Mailing Address - Street 2:
Mailing Address - City:PONTIAC
Mailing Address - State:MI
Mailing Address - Zip Code:48342-2217
Mailing Address - Country:US
Mailing Address - Phone:248-338-5392
Mailing Address - Fax:248-338-5567
Practice Address - Street 1:50 N PERRY ST
Practice Address - Street 2:
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48342-2217
Practice Address - Country:US
Practice Address - Phone:248-338-5392
Practice Address - Fax:248-338-5567
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-25
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101017347207Q00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine