MEDICARE: BARRY A FISHER MD

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	207Q00000X	Family Medicine Physician	35053972	OH
2	207QS0010X	Sports Medicine (Family Medicine) Physician	35053972	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	080152611	OTHER	OH	MEDICARE RR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184617409
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARRY A FISHER MD

Provider Business Mailing Address
First Line	:	PO BOX 711808
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43271-1808
Country	:	US
Telephone Number	:	937-384-4838
Fax Number	:	937-384-4845

Provider Business Practice Location Address
First Line	:	6438 WILMINGTON PIKE
Second Line	:	SUITE 100
City	:	DAYTON
State	:	OH
Zip	:	45459-7010
Country	:	US
Telephone Number	:	937-885-7362
Fax Number	:

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

Provider Enumeration Date	:	08/23/2005
Last Update Date	:	02/17/2009

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Directions to “ BARRY A FISHER MD” Practice Location

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