MEDICARE: RICHARD FISHER MD SC

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	207Q00000X	Family Medicine Physician	27622	WI

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	:	1528366895
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RICHARD FISHER MD SC

Provider Business Mailing Address
First Line	:	3238 S. 16TH STREET
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53215
Country	:	US
Telephone Number	:	414-672-5700
Fax Number	:	414-672-5757

Provider Business Practice Location Address
First Line	:	3238 S. 16TH STREET
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53215
Country	:	US
Telephone Number	:	414-672-5700
Fax Number	:	414-672-5757

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RICHARD M FISHER
Credential	:	MD
Telephone Number	:	414-672-5700

Provider Enumeration Date	:	03/10/2011
Last Update Date	:	03/10/2011

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Directions to “RICHARD FISHER MD SC ” Practice Location

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