Individual
MICHAEL FISHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
940 GA HIGHWAY 96, WARNER ROBINS, GA 31088-2584
(478) 988-1222
Mailing address
314 ROBINS DR, WARNER ROBINS, GA 31088-4610
(478) 918-7966
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101400000X
—
GA
Enumeration date
04/19/2017
Last updated
04/19/2017
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