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1528062924

NPI Code Detail

MEDICARE: MARK F FISHER MD

MEDICARE: MARK F 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	2085R0202X	Diagnostic Radiology Physician	MD00019627	WA
2	2085R0202X	Diagnostic Radiology Physician	5072	ND
3	2085R0202X	Diagnostic Radiology Physician	31273	MN

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1528062924
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK F FISHER MD

Provider Business Mailing Address
First Line	:	801 BROADWAY N
Second Line	:
City	:	FARGO
State	:	ND
Zip	:	58102-3641
Country	:	US
Telephone Number	:	701-234-2309
Fax Number	:

Provider Business Practice Location Address
First Line	:	801 BROADWAY N
Second Line	:
City	:	FARGO
State	:	ND
Zip	:	58102-3641
Country	:	US
Telephone Number	:	701-234-2309
Fax Number	:

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

Provider Enumeration Date	:	06/13/2005
Last Update Date	:	01/18/2012

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Directions to “ MARK F FISHER MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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