Provider Demographics
NPI:1013930270
Name:FISHER, CHRISTOPHER B (PA-C)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:B
Last Name:FISHER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 N CAROLINE ST
Mailing Address - Street 2:#5263
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21287-0882
Mailing Address - Country:US
Mailing Address - Phone:410-955-9551
Mailing Address - Fax:410-502-6816
Practice Address - Street 1:601 N CAROLINE ST
Practice Address - Street 2:#5263
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0882
Practice Address - Country:US
Practice Address - Phone:410-955-9551
Practice Address - Fax:410-502-6816
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2009-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0002892363A00000X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD956LP566Medicare PIN
MDQ76605Medicare UPIN