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NPI Code Detail

MEDICARE: PHESHETTA SHAREE FISHER PHARMD

MEDICARE: PHESHETTA SHAREE FISHER PHARMD
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
1183500000XPharmacist19858NC

General Provider Information

NPI Number : 1588814594
Entity Type Code : Individual
Provider Name (Legal Business Name) : PHESHETTA SHAREE FISHER PHARMD
Provider Business Mailing Address
First Line : 9805 ROCKY RIVER RD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28215-8922
Country : US
Telephone Number : 704-494-3466
Fax Number :
Provider Business Practice Location Address
First Line : 9805 ROCKY RIVER RD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28215-8922
Country : US
Telephone Number : 704-494-3466
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2008
Last Update Date : 07/30/2012

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