Healthcare Provider Details

I. General information

NPI: 1780611285
Provider Name (Legal Business Name): DAVID FISCHER PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1308 STILLWATER DR
SENECA SC
29672-8004
US

IV. Provider business mailing address

1308 STILLWATER DR
SENECA SC
29672-8004
US

V. Phone/Fax

Practice location:
  • Phone: 229-449-1832
  • Fax:
Mailing address:
  • Phone: 229-449-1832
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA9100675
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: