Provider Demographics
NPI:1356703722
Name:MATUSZ-FISHER, ASHLEY (MD)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:MATUSZ-FISHER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 W MITCHELL ST STE 185
Mailing Address - Street 2:
Mailing Address - City:PETOSKEY
Mailing Address - State:MI
Mailing Address - Zip Code:49770-2296
Mailing Address - Country:US
Mailing Address - Phone:231-487-3390
Mailing Address - Fax:231-487-3578
Practice Address - Street 1:560 W MITCHELL ST STE 185
Practice Address - Street 2:
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-2296
Practice Address - Country:US
Practice Address - Phone:231-487-3390
Practice Address - Fax:231-487-3578
Is Sole Proprietor?:No
Enumeration Date:2016-03-24
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2019-01196207R00000X
MI4301507048207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine