MEDICARE: DR. BRUCE D FISHER D.P.M.

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	213E00000X	Podiatrist	145	MT

Other Identifiers

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

General Provider Information

NPI Number	:	1417920521
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRUCE D FISHER D.P.M.

Provider Business Mailing Address
First Line	:	1016 9TH ST S
Second Line	:
City	:	GREAT FALLS
State	:	MT
Zip	:	59405-4401
Country	:	US
Telephone Number	:	406-727-7771
Fax Number	:	406-771-6575

Provider Business Practice Location Address
First Line	:	1016 9TH ST S
Second Line	:
City	:	GREAT FALLS
State	:	MT
Zip	:	59405-4401
Country	:	US
Telephone Number	:	406-262-3462
Fax Number	:	406-771-6575

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

Provider Enumeration Date	:	02/09/2006
Last Update Date	:	03/07/2024

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