Healthcare Provider Details

I. General information

NPI: 1134192859
Provider Name (Legal Business Name): RITA E FISLER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2006
Last Update Date: 09/03/2024
Certification Date: 08/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15215 S 48TH ST STE 120
PHOENIX AZ
85044-9137
US

IV. Provider business mailing address

801 YORK ST
MANITOWOC WI
54220-4630
US

V. Phone/Fax

Practice location:
  • Phone: 480-706-6580
  • Fax: 480-706-8157
Mailing address:
  • Phone: 920-663-9008
  • Fax: 920-684-1439

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number50874
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: