Individual
DR. MARK BRADLEY FISHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1925 MOUNTAIN VIEW AVE, LONGMONT, CO 80501-3128
(720) 718-8305
(303) 485-3377
Mailing address
1925 MOUNTAIN VIEW AVE, LONGMONT, CO 80501-3128
(720) 718-8305
(303) 485-3377
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
036122470
IL
208800000X
Urology Physician
Primary
054743
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
025542
KAISER COMMERCIAL NUMBER
CO
05
—
036122470
—
IL
05
—
61402516
—
CO
Enumeration date
02/05/2008
Last updated
04/29/2022
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