MEDICARE: MICHAEL D FISHER MD

Medicare Provider Information

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	1036080	IN
2	2085R0204X	Vascular & Interventional Radiology Physician	01036080A	IN
3	2085R0202X	Diagnostic Radiology Physician	01036080A	IN

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00032807	OTHER	IN	RAILROAD MEDICARE
2	P00033052	OTHER	IN	RAILROAD MEDICARE
3	P00032826	OTHER	IN	RAILROAD MEDICARE
5	P00032844	OTHER	IN	RAILROAD MEDICARE
7	300123636	OTHER	IN	RAILROAD MEDICARE
8	P00032631	OTHER	IN	RAILROAD MEDICARE
9	P00032644	OTHER	IN	RAILROAD MEDICARE
10	P00033107	OTHER	IN	RAILROAD MEDICARE
11	P00032761	OTHER	IN	RAILROAD MEDICARE
12	P00033227	OTHER	IN	RAILROAD MEDICARE
13	P00033228	OTHER	IN	RAILROAD MEDICARE
14	P00033262	OTHER	IN	RAILROAD MEDICARE
15	P00363050	OTHER	IN	RAILROAD MEDICARE

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	000000203089	OTHER	IN	ANTHEM
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

NPI Number	:	1912991787
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL D FISHER MD

Provider Business Mailing Address
First Line	:	9998 CROSSPOINT BLVD STE 200
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46256-3307
Country	:	US
Telephone Number	:	317-579-2150
Fax Number	:	317-579-2130

Provider Business Practice Location Address
First Line	:	9998 CROSSPOINT BLVD STE 200
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46256-3307
Country	:	US
Telephone Number	:	317-579-2150
Fax Number	:	317-579-2130

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

Provider Enumeration Date	:	09/07/2005
Last Update Date	:	12/24/2020