Individual
MARK DANIEL FISCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1801 N SENATE BOULEVARD, SUITE 310, INDIANAPOLIS, IN 46202-1196
(317) 962-2500
(317) 962-2515
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
0106933A
IN
207RC0000X
Cardiovascular Disease Physician
241325
NY
207RC0000X
Cardiovascular Disease Physician
25MA08811000
NJ
207RI0011X
Interventional Cardiology Physician
0106933A
IN
207RI0011X
Interventional Cardiology Physician
Primary
01069933A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000728994
ANTHEM PIN
IN
05
—
201027340
—
IN
01
—
P01002399
RAILROAD MEDICARE PTAN
IN
Enumeration date
07/10/2007
Last updated
01/05/2022
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