Healthcare Provider Details

I. General information

NPI: 1588824908
Provider Name (Legal Business Name): CYNTHIA MARIE FISHER D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CYNTHIA MARIE MAAS D.O.

II. Dates (important events)

Enumeration Date: 06/10/2008
Last Update Date: 03/01/2022
Certification Date: 03/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 N WESTHAVEN DR
OSHKOSH WI
54904-6926
US

IV. Provider business mailing address

3 NEENAH CTR
NEENAH WI
54956-3070
US

V. Phone/Fax

Practice location:
  • Phone: 920-237-5000
  • Fax:
Mailing address:
  • Phone: 920-237-5000
  • Fax: 920-237-5001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number55891-21
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: