Healthcare Provider Details

I. General information

NPI: 1497867972
Provider Name (Legal Business Name): JOHN ROBERT FISCHER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

606 24TH AVE S STE 300
MINNEAPOLIS MN
55454-1437
US

IV. Provider business mailing address

6900 GEORGIA AVE NW
WASHINGTON DC
20307-0003
US

V. Phone/Fax

Practice location:
  • Phone: 612-273-7111
  • Fax: 612-273-7112
Mailing address:
  • Phone: 202-782-8440
  • Fax: 202-782-9278

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number33284
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: