Provider Demographics
NPI:1952406910
Name:FECHER, ALISON M (MD)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:M
Last Name:FECHER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6920 POINTE INVERNESS WAY STE 200
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46804-7934
Mailing Address - Country:US
Mailing Address - Phone:260-479-3514
Mailing Address - Fax:260-479-3520
Practice Address - Street 1:7900 W JEFFERSON BLVD STE 306
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46804-4128
Practice Address - Country:US
Practice Address - Phone:260-458-3610
Practice Address - Fax:260-458-3611
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD427231207RC0200X
IN01065558A2086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200941540Medicaid
IN260690147OtherMEDICARE PIN
PA1014708280001Medicaid
PA1775073OtherHIGHMARK
IN233690JJJMedicare PIN
IN000000624375OtherANTHEM PIN
INP00848306Medicare PIN
PA1014708280001Medicaid