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General NPI Number Information
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NPI Number | 1215256839
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Entity Type | Individual
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Provider Name | BRENT EDWARD FISHER M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/21/2010
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Last Update Date | 01/10/2025
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Provider Practice Location Address
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Address Line | 159 WEAVER BLVD
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City | WEAVERVILLE
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State | NC
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Zip | 28787-8345
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Country | US
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Telephone | 828-258-8800
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5105
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City | BELFAST
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State | ME
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Zip | 04915-5100
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Country | US
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Telephone | 864-522-8603
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2015-02102
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | 32805
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | 2015-02102
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License Number State | NC
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