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NPI Code Detail

MEDICARE: LARRY S FISHER MD PC

MEDICARE: LARRY S FISHER MD PC
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 Physician

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 : 1588798516
Entity Type Code : Organization
Provider Name (Legal Business Name) : LARRY S FISHER MD PC
Provider Business Mailing Address
First Line : 3464 S WILLOW ST
Second Line : SUITE 096
City : DENVER
State : CO
Zip : 80231-4531
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4101 W CONEJOS PL
Second Line : SUITE 300
City : DENVER
State : CO
Zip : 80204-1377
Country : US
Telephone Number : 303-629-2091
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : LARRY S FISHER
Credential :
Telephone Number : 303-629-2091
Provider Enumeration Date : 03/14/2007
Last Update Date : 08/22/2020

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