MEDICARE: DR. DAVID W FISHER DC

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
1	111N00000X	Chiropractor	3155	MN
2	111NR0400X	Rehabilitation Chiropractor	DACRB	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3C750FI	OTHER	MN	BCBS

General Provider Information

NPI Number	:	1417032061
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID W FISHER DC

Provider Business Mailing Address
First Line	:	1118 E SUPERIOR ST
Second Line	:	FISHER CHIROPRACTIC CLINIC LTD
City	:	DULUTH
State	:	MN
Zip	:	55802-2217
Country	:	US
Telephone Number	:	218-728-3639
Fax Number	:	218-728-2603

Provider Business Practice Location Address
First Line	:	1118 E SUPERIOR ST
Second Line	:	FISHER CHIROPRACTIC CLINIC LTD
City	:	DULUTH
State	:	MN
Zip	:	55802-2217
Country	:	US
Telephone Number	:	218-728-3639
Fax Number	:	218-728-2603

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/25/2006
Last Update Date	:	09/11/2025

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Directions to “ DR. DAVID W FISHER DC” Practice Location

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