Healthcare Provider Details

I. General information

NPI: 1952601080
Provider Name (Legal Business Name): DAVID J FISCHER M D P C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2010
Last Update Date: 12/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4707 CONNECTICUT AVE NW APT 101
WASHINGTON DC
20008-5619
US

IV. Provider business mailing address

4707 CONNECTICUT AVE NW APT 101
WASHINGTON DC
20008-5619
US

V. Phone/Fax

Practice location:
  • Phone: 202-686-0114
  • Fax:
Mailing address:
  • Phone: 202-686-0114
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number4517
License Number StateDC

VIII. Authorized Official

Name: MRS. LORRAINE FISCHER
Title or Position: MANAGER
Credential:
Phone: 301-299-2832