Healthcare Provider Details

I. General information

NPI: 1922182849
Provider Name (Legal Business Name): HARRY WILLIAM FISCHER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17752 CHARIOT RD
ELKADER IA
52043-8136
US

IV. Provider business mailing address

17752 CHARIOT RD
ELKADER IA
52043-8136
US

V. Phone/Fax

Practice location:
  • Phone: 563-245-3268
  • Fax:
Mailing address:
  • Phone: 563-245-3268
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number105181
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number19183
License Number StateIA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier105181
Identifier TypeOTHER
Identifier StateMO
Identifier IssuerLICENSE NUMBER
# 2
Identifier234925601
Identifier TypeOTHER
Identifier StateMO
Identifier IssuerBNDD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: