Individual
DR. THOMAS DAVID FISHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
209 WEST 27TH STREET, LUMBERTON, NC 28358-3016
(910) 738-8222
(910) 671-0846
Mailing address
P.O. BOX 1527, LUMBERTON, NC 28359-1527
(910) 738-8222
(910) 671-0846
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
2010-00013
NC
2085R0202X
Diagnostic Radiology Physician
4301081014
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
156P8
BLUE CROSS BLUE SHIELD
NC
01
—
310A710590
BCBS GROUP PIN
MI
05
—
4522353
—
MI
05
—
5913863
—
NC
01
—
DD4837
MEDICARE RR GROUP PIN
MI
Enumeration date
10/24/2006
Last updated
07/20/2010
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