MEDICARE: DR. RONALD FISCHER M.D.

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	208100000X	Physical Medicine & Rehabilitation Physician	R6J45	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0004598747	OTHER	MO	AETNA
2	138778	OTHER	MO	HEALTHLINK
3	757749	OTHER	MO	UNITED HEALTHCARE
4	000000602384	OTHER	MO	BLUE CROSS
5	475249	OTHER	MO	GROUP HEALTH PLAN

General Provider Information

NPI Number	:	1508896077
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RONALD FISCHER M.D.

Provider Business Mailing Address
First Line	:	224 S WOODS MILL RD
Second Line	:	STE 570 S
City	:	CHESTERFIELD
State	:	MO
Zip	:	63017-3513
Country	:	US
Telephone Number	:	314-205-6898
Fax Number	:	314-434-8457

Provider Business Practice Location Address
First Line	:	224 S WOODS MILL RD
Second Line	:	STE 570 S
City	:	CHESTERFIELD
State	:	MO
Zip	:	63017-3513
Country	:	US
Telephone Number	:	314-205-6898
Fax Number	:	314-434-8457

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

Provider Enumeration Date	:	07/03/2006
Last Update Date	:	12/02/2016

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Directions to “ DR. RONALD FISCHER M.D.” Practice Location

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