Healthcare Provider Details

I. General information

NPI: 1487614863
Provider Name (Legal Business Name): LEONARD STEPHEN FISCHER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2006
Last Update Date: 07/27/2021
Certification Date: 07/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3620 JOSEPH SIEWICK DR SUITE 307
FAIRFAX VA
22033-1756
US

IV. Provider business mailing address

500 UNIVERSITY DRIVE CA410
HERSHEY PA
17033-2360
US

V. Phone/Fax

Practice location:
  • Phone: 703-281-1023
  • Fax: 703-620-2331
Mailing address:
  • Phone: 800-243-1455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberMD469668
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: