Provider Demographics
NPI:1689762841
Name:FLEISCHER, GARY D (MD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:D
Last Name:FLEISCHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 TYLER ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060-2951
Mailing Address - Country:US
Mailing Address - Phone:603-521-7413
Mailing Address - Fax:603-402-9348
Practice Address - Street 1:19 TYLER ST
Practice Address - Street 2:SUITE 104
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-2951
Practice Address - Country:US
Practice Address - Phone:603-521-7413
Practice Address - Fax:603-402-9348
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2014-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH13958207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30207753Medicaid
NH30207753Medicaid
NH0422560001Medicare NSC