Individual
JEREMY GABRIEL FISHER
Active
Individual
JEREMY GABRIEL FISHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
35.128754
OH
2086S0120X
Pediatric Surgery Physician
Primary
61514
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0292539
—
OH
01
—
H635870
CGS-MEDICARE
OH
05
—
Q060604
—
TN
Enumeration date
04/28/2009
Last updated
09/29/2023
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