Provider Demographics
NPI:1205946589
Name:FISCHER, CAROL ANNE (MD)
Entity type:Individual
Prefix:DR
First Name:CAROL
Middle Name:ANNE
Last Name:FISCHER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1331 PRAIRIE AVE
Mailing Address - Street 2:#2
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82009
Mailing Address - Country:US
Mailing Address - Phone:307-778-3121
Mailing Address - Fax:307-637-1558
Practice Address - Street 1:1331 PRAIRIE AVE
Practice Address - Street 2:#2
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82009
Practice Address - Country:US
Practice Address - Phone:307-778-3121
Practice Address - Fax:307-637-1558
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2008-04-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WY3456A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY104197500Medicaid
WY104197500Medicaid
W302516Medicare PIN