Provider Demographics
NPI:1710933478
Name:FISHER, MARC ALAN (DPM)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:ALAN
Last Name:FISHER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 E SILVER ST
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01085-4449
Mailing Address - Country:US
Mailing Address - Phone:413-562-5611
Mailing Address - Fax:413-562-5622
Practice Address - Street 1:48 E SILVER ST
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:MA
Practice Address - Zip Code:01085-4449
Practice Address - Country:US
Practice Address - Phone:413-562-5611
Practice Address - Fax:413-562-5622
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-25
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1588213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY70717Medicare ID - Type UnspecifiedMEDICARE ID #
MAT58733Medicare UPIN