Healthcare Provider Details

I. General information

NPI: 1295951820
Provider Name (Legal Business Name): TAMARA FISCHER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6017 TWILIGHT CT
BALTIMORE MD
21206-2256
US

IV. Provider business mailing address

6017 TWILIGHT CT
BALTIMORE MD
21206-2256
US

V. Phone/Fax

Practice location:
  • Phone: 410-866-6633
  • Fax:
Mailing address:
  • Phone: 410-866-6633
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License NumberLP31184
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: