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General NPI Number Information
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NPI Number | 1255392098
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Entity Type | Individual
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Provider Name | STEPHEN T FISHER D.O.
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Gender | Male
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Dates
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Enumeration Date | 03/31/2006
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Last Update Date | 12/29/2020
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Provider Practice Location Address
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Address Line | 1593 OLENTANGY RD
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City | GALION
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State | OH
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Zip | 44833-9762
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Country | US
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Telephone | 419-468-7785
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Fax | 419-468-7295
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Provider Business Mailing Address
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Address Line | 700 N COLUMBUS ST
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City | CRESTLINE
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State | OH
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Zip | 44827-1455
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Country | US
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Telephone | 419-468-7785
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 34004257
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License Number State | OH
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