Provider Demographics
NPI:1962496687
Name:FISHBEIN, DONN S (MD)
Entity Type:Individual
Prefix:
First Name:DONN
Middle Name:S
Last Name:FISHBEIN
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 1:800 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:COLDWATER
Mailing Address - State:OH
Mailing Address - Zip Code:45828-1613
Mailing Address - Country:US
Mailing Address - Phone:419-678-5163
Mailing Address - Fax:
Practice Address - Street 1:800 W MAIN ST
Practice Address - Street 2:
Practice Address - City:COLDWATER
Practice Address - State:OH
Practice Address - Zip Code:45828-1613
Practice Address - Country:US
Practice Address - Phone:419-678-5163
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-08
Last Update Date:2011-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35062818207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0866335Medicaid
OH000000113553OtherANTHEM
OH0715671Medicare PIN
OH000000113553OtherANTHEM
OH0866335Medicaid
OH0715672Medicare PIN