MEDICARE: CHRISTOPHER FISHER MD LLC

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	261QP3300X	Pain Clinic/Center	13659	NV

General Provider Information

NPI Number	:	1538531538
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHRISTOPHER FISHER MD LLC

Provider Business Mailing Address
First Line	:	10124 DESERT WIND DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89144-6508
Country	:	US
Telephone Number	:	702-556-0519
Fax Number	:

Provider Business Practice Location Address
First Line	:	7140 SMOKE RANCH RD
Second Line	:	STE 150
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-3157
Country	:	US
Telephone Number	:	702-556-0519
Fax Number	:

Authorized Official
Title or Position	:	PROVIDER MD
Name	:	CHRISTOPHER FISHER
Credential	:	MD
Telephone Number	:	702-556-0519

Provider Enumeration Date	:	10/29/2015
Last Update Date	:	10/29/2015

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