Healthcare Provider Details

I. General information

NPI: 1639289713
Provider Name (Legal Business Name): MICHAEL ANDREW FISCHER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 01/08/2021
Certification Date: 01/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 BARTLETT ST STE 305
LOWELL MA
01852-1318
US

IV. Provider business mailing address

33 BARTLETT ST STE 305
LOWELL MA
01852-1318
US

V. Phone/Fax

Practice location:
  • Phone: 978-452-2200
  • Fax:
Mailing address:
  • Phone: 978-452-2200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number15376
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: