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Individual

MR. JOSHUA D FISHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MPAS, PA-C

Contact information

Practice address
190 E BANNOCK ST FL 10, BOISE, ID 83712-6241
(208) 381-2555
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
363AS0400X
Surgical Physician Assistant
Primary
PA-2257
ID

Other

Enumeration date
05/16/2022
Last updated
07/13/2022
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