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Individual

GARY T FISCHBACH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6124 WOODSIDE EXECUTIVE CT, AIKEN, SC 29803-3820
(803) 226-0112
(803) 226-0132
Mailing address
6124 WOODSIDE EXECUTIVE CT, AIKEN, SC 29803-3820
(803) 226-0112
(803) 226-0132

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0502521
SC
207R00000X
Internal Medicine Physician
Primary
10758
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
107583
SC
01
562134996
BCBS PROVIDER NUMBER
SC
Enumeration date
04/26/2006
Last updated
05/17/2026
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