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General NPI Number Information
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NPI Number | 1841429156
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Entity Type | Individual
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Provider Name | MICHAEL ALAN FISHMAN MD
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Gender | Male
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Dates
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Enumeration Date | 07/08/2009
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Last Update Date | 10/24/2024
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Provider Practice Location Address
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Address Line | 755 NORMAN DR
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City | LEBANON
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State | PA
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Zip | 17042-7497
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Country | US
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Telephone | 717-273-6706
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Fax | 717-273-9910
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Provider Business Mailing Address
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Address Line | 755 NORMAN DR
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City | LEBANON
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State | PA
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Zip | 17042-3704
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Country | US
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Telephone | 917-543-6588
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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 | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | MD450715
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | MD450715
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | C1-0011247
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License Number State | DE
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Taxonomy #4
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | C1-0011247
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License Number State | DE
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Taxonomy #5
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | MD450715
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License Number State | PA
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