Individual
SOFIA FISKE
Active
Individual
SOFIA FISKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
C0005859
MD
363AM0700X
Medical Physician Assistant
Primary
PA031576
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C0005859
MD LICENSE NUMBER
MD
Enumeration date
08/17/2015
Last updated
05/10/2019
Update your record
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