Individual
MARK F FISHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
801 BROADWAY N, FARGO, ND 58102-3641
(701) 234-2309
Mailing address
801 BROADWAY N, FARGO, ND 58102-3641
(701) 234-2309
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
31273
MN
2085R0202X
Diagnostic Radiology Physician
Primary
5072
ND
2085R0202X
Diagnostic Radiology Physician
MD00019627
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
14202
—
ND
05
—
8143737
—
WA
Enumeration date
06/13/2005
Last updated
01/18/2012
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