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NPI Code Detail

MEDICARE: MRS. KRISTEN FISCHER JILG D.M.D.

MEDICARE: MRS. KRISTEN FISCHER JILG D.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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1699207258
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KRISTEN FISCHER JILG D.M.D.
Provider Business Mailing Address
First Line : 6 PROFESSIONAL DR
Second Line :
City : SNOW HILL
State : NC
Zip : 28580-1333
Country : US
Telephone Number : 252-747-3846
Fax Number :
Provider Business Practice Location Address
First Line : 6 PROFESSIONAL DR
Second Line :
City : SNOW HILL
State : NC
Zip : 28580-1333
Country : US
Telephone Number : 252-747-3846
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/31/2017
Last Update Date : 03/31/2017

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