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General NPI Number Information
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NPI Number | 1871512590
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Entity Type | Individual
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Provider Name | MARC FISHER MD
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Gender | Male
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1111 MEDICAL CENTER BLVD STE 313
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City | MARRERO
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State | LA
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Zip | 70072-3154
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Country | US
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Telephone | 504-361-0234
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Fax | 504-361-8177
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Provider Business Mailing Address
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Address Line | 1111 MEDICAL CENTER BLVD NORTH TOWER SUITE 313
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City | MARRERO
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State | LA
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Zip | 70072
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Country | US
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Telephone | 504-361-0234
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Fax | 504-361-8177
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 018209
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License Number State | LA
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