MEDICARE: DR. MICHAEL JOHN FISCHER D.D.S.

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	1223G0001X	General Practice Dentistry	14403	MI

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	:	1861507154
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL JOHN FISCHER D.D.S.

Provider Business Mailing Address
First Line	:	4552 CHERRYWOOD CT
Second Line	:
City	:	MUSKEGON
State	:	MI
Zip	:	49441-4810
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3579 HENRY ST
Second Line	:	SUITE 110
City	:	MUSKEGON
State	:	MI
Zip	:	49441-6720
Country	:	US
Telephone Number	:	231-739-8889
Fax Number	:	231-733-3117

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/20/2006
Last Update Date	:	07/08/2007

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