Healthcare Provider Details
I. General information
NPI: 1396810891
Provider Name (Legal Business Name): ROBIN A FISCHER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/21/2006
Last Update Date: 03/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
BCBS OF MA ONE ENTERPRISE DRIVE
QUINCY MA
02171
US
IV. Provider business mailing address
BCBS OF MA ONE ENTERPRISE DRIVE
QUINCY MA
02171
US
V. Phone/Fax
- Phone: 617-246-6140
- Fax:
- Phone: 617-246-6140
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VE0102X |
| Taxonomy | Reproductive Endocrinology Physician |
| License Number | 56975 |
| License Number State | MA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | 56975 |
| License Number State | MA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: