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Individual

MR. LANCE STEVEN FISHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
5702 W CAMPBELL AVE, PHOENIX, AZ 85031
(623) 848-5000
Mailing address
13512 W READE AVE, LITCHFIELD PARK, AZ 85340-4019
(623) 535-4372

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
11450
MN
207P00000X
Emergency Medicine Physician
Primary
2412
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3981220
EVERCARE GROUP
AZ
01
453051001
GROUP HEALTH GROUP
AZ
05
538192
AZ
01
860373636
HUMANA GROUP
AZ
01
AW1436
HEALTHNET GROUP
AZ
Enumeration date
12/06/2005
Last updated
01/29/2016
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