MEDICARE: DR. NEIL WILLIAM FISHER D.O.

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	208600000X	Surgery Physician	OS005432L	PA

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	:	1821069956
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NEIL WILLIAM FISHER D.O.

Provider Business Mailing Address
First Line	:	PO BOX 783311
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19178-3311
Country	:	US
Telephone Number	:	484-884-4500
Fax Number	:	484-884-0699

Provider Business Practice Location Address
First Line	:	48 TUNNEL RD
Second Line	:	SUITE 205
City	:	POTTSVILLE
State	:	PA
Zip	:	17901-3875
Country	:	US
Telephone Number	:	570-622-1400
Fax Number	:	570-622-8900

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

Provider Enumeration Date	:	01/27/2006
Last Update Date	:	12/07/2021

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Directions to “ DR. NEIL WILLIAM FISHER D.O.” Practice Location

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