Individual
DR. MARK FISHERKELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
90 QUARRY ST, WILLIMANTIC, CT 06226-1225
(860) 456-2898
(860) 456-3078
Mailing address
90 QUARRY ST, WILLIMANTIC, CT 06226-1225
(860) 456-2898
(860) 456-3078
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
021796
CT
207UN0901X
Nuclear Cardiology Physician
021796
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001217967
—
CT
Enumeration date
05/05/2006
Last updated
05/04/2012
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