Individual
JONATHAN ROSS FISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1233 34TH ST NW, BEMIDJI, MN 56601-5112
(218) 333-5283
(218) 333-5360
Mailing address
1233 34TH ST NW, BEMIDJI, MN 56601-5112
(218) 333-5283
(218) 333-5360
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
11109
ND
2085R0202X
Diagnostic Radiology Physician
24357
OK
2085R0202X
Diagnostic Radiology Physician
Primary
46718
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10732
—
ND
Enumeration date
02/05/2007
Last updated
03/29/2022
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