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NPI Code Detail

MEDICARE: DR. LARRY S FISHER MD

MEDICARE: DR. LARRY S FISHER MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RI0200XInfectious Disease Physician17206CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1255333076
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LARRY S FISHER MD
Provider Business Mailing Address
First Line : 1930 S FEDERAL BLVD
Second Line :
City : DENVER
State : CO
Zip : 80219-5501
Country : US
Telephone Number : 303-935-9142
Fax Number : 303-934-7332
Provider Business Practice Location Address
First Line : 1930 S FEDERAL BLVD
Second Line :
City : DENVER
State : CO
Zip : 80219-5501
Country : US
Telephone Number : 303-935-9142
Fax Number : 303-934-7332
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2005
Last Update Date : 06/26/2014

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