Provider Demographics
NPI:1336183201
Name:FISHER, BRIAN S (PA)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:S
Last Name:FISHER
Suffix:
Gender:M
Credentials:PA
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:540 LAFAYETTE RD
Mailing Address - Street 2:SUITE 8
Mailing Address - City:HAMPTON
Mailing Address - State:NH
Mailing Address - Zip Code:03842-3344
Mailing Address - Country:US
Mailing Address - Phone:603-926-0088
Mailing Address - Fax:603-926-2853
Practice Address - Street 1:250 PLEASANT ST
Practice Address - Street 2:ER DEPARTMENT
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-7539
Practice Address - Country:US
Practice Address - Phone:603-225-7000
Practice Address - Fax:603-224-6527
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH0375P363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHAP1372Medicare ID - Type Unspecified
P19148Medicare UPIN