Provider Demographics
NPI:1740326479
Name:FISHER, CATHERINE PATRICIA (MD)
Entity type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:PATRICIA
Last Name: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 1:2916 CARRIAGE CIR
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58503-0113
Mailing Address - Country:US
Mailing Address - Phone:701-471-2141
Mailing Address - Fax:
Practice Address - Street 1:2916 CARRIAGE CIR
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58503-0113
Practice Address - Country:US
Practice Address - Phone:701-471-2141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND6467207ZP0105X, 207ZP0102X, 207ZP0102X
MN36529207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Yes207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F79678Medicare UPIN