Provider Demographics
NPI:1255930970
Name:FISCHER, DEREK E
Entity type:Individual
Prefix:
First Name:DEREK
Middle Name:E
Last Name:FISCHER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8121 MILL CREEK CIR
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-5804
Mailing Address - Country:US
Mailing Address - Phone:513-668-6589
Mailing Address - Fax:
Practice Address - Street 1:8121 MILL CREEK CIR
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-5804
Practice Address - Country:US
Practice Address - Phone:513-668-6589
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-23
Last Update Date:2020-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care