Provider Demographics
NPI:1811052434
Name:FISCHER, MICHAEL S (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:S
Last Name:FISCHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4200 LAKE OTIS PKWY
Mailing Address - Street 2:SUITE 304
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5226
Mailing Address - Country:US
Mailing Address - Phone:907-561-9444
Mailing Address - Fax:907-561-9446
Practice Address - Street 1:4200 LAKE OTIS PKWY
Practice Address - Street 2:SUITE 304
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5226
Practice Address - Country:US
Practice Address - Phone:907-561-9444
Practice Address - Fax:907-561-9446
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2011-12-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AK2741207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKE75049Medicare UPIN