Individual
MICHAEL NATHANIEL FISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
516 E. NIZHONI BLVD, GALLUP, NM 87301-1337
(505) 722-1000
(505) 722-1421
Mailing address
10646 S ERIE AVE, TULSA, OK 74137-7233
(918) 269-5123
(918) 298-2694
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
2005017275
MO
Other
Enumeration date
02/27/2006
Last updated
11/07/2012
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