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General NPI Number Information
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NPI Number | 1750376893
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Entity Type | Individual
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Provider Name | MATTHEW FISHER
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Gender | Male
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Dates
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Enumeration Date | 09/14/2005
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Last Update Date | 06/18/2025
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Provider Practice Location Address
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Address Line | 15 REGIONAL DR
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City | PINEHURST
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State | NC
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Zip | 28374-8850
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Country | US
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Telephone | 910-295-5511
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Fax |
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Provider Business Mailing Address
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Address Line | 2 HOT METAL ST QUANTUM ONE, SUITE 001
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City | PITTSBURGH
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State | PA
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Zip | 15203-2348
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Country | US
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Telephone |
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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 | 00416
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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 | MD422593
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License Number State | PA
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