Healthcare Provider Details

I. General information

NPI: 1700190287
Provider Name (Legal Business Name): EDWARD G FISHER MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2010
Last Update Date: 07/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3536 MINNESOTA AVE SE #1
WASHINGTON DC
20019-8270
US

IV. Provider business mailing address

3536 MINNESOTA AVE SE #1
WASHINGTON DC
20019-8270
US

V. Phone/Fax

Practice location:
  • Phone: 202-581-0200
  • Fax: 202-581-1040
Mailing address:
  • Phone: 202-581-0200
  • Fax: 202-581-1040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberMD25268
License Number StateDC

VIII. Authorized Official

Name: EDWARD GUY FISHER
Title or Position: PRESIDENT/OWNER
Credential: MD
Phone: 202-581-0200