Provider Demographics
NPI:1932175064
Name:FISHER, DAVID C (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:C
Last Name:FISHER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:196 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BUZZARDS BAY
Mailing Address - State:MA
Mailing Address - Zip Code:02532-3233
Mailing Address - Country:US
Mailing Address - Phone:508-759-8852
Mailing Address - Fax:508-759-0192
Practice Address - Street 1:196 MAIN ST
Practice Address - Street 2:
Practice Address - City:BUZZARDS BAY
Practice Address - State:MA
Practice Address - Zip Code:02532-3233
Practice Address - Country:US
Practice Address - Phone:508-759-8852
Practice Address - Fax:508-759-0192
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1748111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1610627Medicaid
MA768825OtherTUFTS
MA57566OtherCIGNA
MA4400497OtherUNITED HEALTHCARE
MA35264OtherHARVARD PILGRIM HEALTH CA
MAY36232OtherBLUE CROSS BLUE SHIELD
MA4400497OtherUNITED HEALTHCARE