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General NPI Number Information
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NPI Number | 1235105073
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Entity Type | Individual
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Provider Name | ZACHARY ETHAN FISHER M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/23/2006
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Last Update Date | 05/30/2021
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Provider Practice Location Address
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Address Line | 1 JARRETT WHITE ROAD
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City | HONOLULU
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State | HI
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Zip | 96859-1541
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Country | US
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Telephone | 808-433-5313
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Fax |
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Provider Business Mailing Address
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Address Line | 1717 ALA WAI BLVD
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City | HONOLULU
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State | HI
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Zip | 96815-1541
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Country | US
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Telephone | 808-781-2495
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 13328
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License Number State | HI
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