MEDICARE: MS. CHERYL A. FISHMAN MSPT

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	225100000X	Physical Therapist	10386	NC
2	225100000X	Physical Therapist	22135	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7040761	OTHER	NC	AETNA
2	079WK	OTHER	NC	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	694564/Z965FN	OTHER	NC	ACN/MPN/UHC

General Provider Information

NPI Number	:	1275551962
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CHERYL A. FISHMAN MSPT

Provider Business Mailing Address
First Line	:	1026 CROMWELL BRIDGE ROAD
Second Line	:	CARE RESOURCES
City	:	BALTIMORE
State	:	MD
Zip	:	21286
Country	:	US
Telephone Number	:	410-583-1515
Fax Number	:	410-583-2491

Provider Business Practice Location Address
First Line	:	1026 CROMWELL BRIDGE ROAD
Second Line	:	CARE RESOURCES
City	:	BALTIMORE
State	:	MD
Zip	:	21286
Country	:	US
Telephone Number	:	410-583-1515
Fax Number	:	410-583-2491

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

Provider Enumeration Date	:	07/18/2006
Last Update Date	:	03/03/2009

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