Healthcare Provider Details

I. General information

NPI: 1316905581
Provider Name (Legal Business Name): FISHER & GRANDIA, M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 11/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

52 THOMAS JOHNSON DR
FREDERICK MD
21702-4300
US

IV. Provider business mailing address

52 THOMAS JOHNSON DR
FREDERICK MD
21702-4300
US

V. Phone/Fax

Practice location:
  • Phone: 301-663-9573
  • Fax: 301-663-6446
Mailing address:
  • Phone: 301-663-9573
  • Fax: 301-663-6446

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. ANNE HOLLISTER
Title or Position: OFFICE MANAGER
Credential:
Phone: 301-663-9573