Provider Demographics
NPI:1295899979
Name:FISHMAN, HENRY JAMES
Entity type:Individual
Prefix:DR
First Name:HENRY
Middle Name:JAMES
Last Name:FISHMAN
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 1:2021 K ST NW STE 420
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20006-1017
Mailing Address - Country:US
Mailing Address - Phone:202-833-3500
Mailing Address - Fax:202-833-3503
Practice Address - Street 1:2021 K ST NW STE 420
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006-1017
Practice Address - Country:US
Practice Address - Phone:202-833-3500
Practice Address - Fax:202-833-3503
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCCS8800492207K00000X
DCMD12429207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Single Specialty
No207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC1922409705OtherMEDICARE GROUP NPI
DCD09371Medicare UPIN
DC133855Medicare ID - Type Unspecified