Individual
DR. KEITH C FISCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
510 S KINGSHIGHWAY BLVD, SAINT LOUIS, MO 63110-1016
(314) 362-7200
(314) 747-4189
Mailing address
660 S EUCLID AVE, C B 8131, SAINT LOUIS, MO 63110-1010
(314) 362-7200
(314) 747-4189
Taxonomy
Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
Primary
R7780
MO
2085R0202X
Diagnostic Radiology Physician
R7780
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
202768412
—
MO
05
—
ENROLLED
—
IL
Enumeration date
10/03/2006
Last updated
01/24/2018
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