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Individual

BRUCE L FISHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3920 DUTCHMANS LN STE 316, LOUISVILLE, KY 40207-4702
(502) 585-4321
(502) 566-6338
Mailing address
100 E LIBERTY ST STE 800, LOUISVILLE, KY 40202-1428
(502) 585-4321
(502) 566-6338

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
01039993A
IN
207RC0000X
Cardiovascular Disease Physician
Primary
23170
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
060014169
RAILROAD MEDICARE
IN
01
060057270
RAILROAD MEDICARE
KY
05
200009600
IN
05
64231707
KY
01
P00258374
RAILROAD MEDICARE
KY
Enumeration date
10/07/2005
Last updated
03/27/2018
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