Healthcare Provider Details

I. General information

NPI: 1912909888
Provider Name (Legal Business Name): DAVID JOSHUA FISHER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/11/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 S 18TH ST
COLUMBUS OH
43205-2654
US

IV. Provider business mailing address

555 S 18TH ST
COLUMBUS OH
43205-2654
US

V. Phone/Fax

Practice location:
  • Phone: 614-722-4554
  • Fax: 614-722-4565
Mailing address:
  • Phone: 614-722-4554
  • Fax: 614-722-4565

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number35068880
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: