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General NPI Number Information
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NPI Number | 1285457077
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Entity Type | Individual
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Provider Name | MAISIE FISHER PA-C
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Gender | Female
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Dates
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Enumeration Date | 11/01/2024
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Last Update Date | 12/06/2024
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Provider Practice Location Address
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Address Line | 322 W SOUTH ST
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City | UNION
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State | SC
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Zip | 29379-2839
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Country | US
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Telephone | 864-301-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 782 RILEY RD
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City | BUFFALO
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State | SC
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Zip | 29321-2509
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Country | US
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Telephone | 864-441-4520
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 5564
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License Number State | SC
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