Healthcare Provider Details

I. General information

NPI: 1073932810
Provider Name (Legal Business Name): LYTIA FISHER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2014
Last Update Date: 05/16/2024
Certification Date: 05/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7141 SECURITY BLVD
WINDSOR MILL MD
21244-1800
US

IV. Provider business mailing address

7141 SECURITY BLVD
WINDSOR MILL MD
21244-1811
US

V. Phone/Fax

Practice location:
  • Phone: 443-663-6000
  • Fax:
Mailing address:
  • Phone: 443-663-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberD85702
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: