MEDICARE: WILLIAM D FISHCO DPM 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
1	213E00000X	Podiatrist

General Provider Information

NPI Number	:	1598716706
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WILLIAM D FISHCO DPM PC

Provider Business Mailing Address
First Line	:	41818 N VENTURE DR
Second Line	:	SUITE 110
City	:	ANTHEM
State	:	AZ
Zip	:	85086-3188
Country	:	US
Telephone Number	:	623-551-5000
Fax Number	:	800-530-9132

Provider Business Practice Location Address
First Line	:	41818 N VENTURE DR
Second Line	:	SUITE 110
City	:	ANTHEM
State	:	AZ
Zip	:	85086-3188
Country	:	US
Telephone Number	:	623-551-5000
Fax Number	:	800-530-9132

Authorized Official
Title or Position	:	PROVIDER
Name	:	WILLIAM D FISHCO
Credential	:	DPM
Telephone Number	:	602-993-2700

Provider Enumeration Date	:	05/12/2006
Last Update Date	:	08/17/2018

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