# MR. DANIEL JAMES FISHER

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1104137116
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 01070949A | IN | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | 11015552A | IN | — |

## Other

- **Enumeration date:** 06/24/2010
- **Last updated:** 06/09/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 201061920 | — | IN |
| 01 | — | P01221095 | RR MEDICARE PTAN | IN |