Individual
KEVIN ANDREW FISHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2500 W 12TH ST, ERIE, PA 16505-4508
(814) 838-9000
(814) 838-0462
Mailing address
2500 W 12TH ST, ERIE, PA 16505-4508
(814) 838-9000
(814) 838-0462
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
G49070
CA
2085R0001X
Radiation Oncology Physician
Primary
MD445161
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G490700
—
CA
05
—
102710446
—
PA
01
—
P00681332
RAILROAD MEDICARE
—
Enumeration date
08/16/2005
Last updated
08/14/2012
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