Healthcare Provider Details

I. General information

NPI: 1073786158
Provider Name (Legal Business Name): JOHN R FISCHER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2008
Last Update Date: 07/26/2024
Certification Date: 07/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

A.T. AUGUSTA MILITARY MEDICAL CENTER 9300 DEWITT LOOP
FORT BELVOIR VA
22060
US

IV. Provider business mailing address

PO BOX 763
MORGANTOWN WV
26507-0763
US

V. Phone/Fax

Practice location:
  • Phone: 571-231-3162
  • Fax:
Mailing address:
  • Phone: 800-541-4009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number3270
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: