Individual
REXFORD REYNOLD FISHER III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
6615 ACADEMIC AVE, RALEIGH, NC 27616-8094
(585) 694-0715
Mailing address
6615 ACADEMIC AVE, RALEIGH, NC 27616-8094
(585) 694-0715
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0010-11302
NC
363A00000X
Physician Assistant
0010-11302
NC
363AM0700X
Medical Physician Assistant
Primary
—
NC
363AS0400X
Surgical Physician Assistant
0010-11302
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/30/2020
Last updated
12/01/2023
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