MEDICARE: STEPHEN FISHER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1134977275
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHEN FISHER

Provider Business Mailing Address
First Line	:	3010 LOCUST ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80207-2845
Country	:	US
Telephone Number	:	720-333-1788
Fax Number	:

Provider Business Practice Location Address
First Line	:	3010 LOCUST ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80207-2845
Country	:	US
Telephone Number	:	720-333-1788
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/13/2024
Last Update Date	:	05/13/2024

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Directions to “ STEPHEN FISHER ” Practice Location

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