Individual
MASON FISHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3333 EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9493
(616) 364-4200
Mailing address
3333 EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9493
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
25770101
MI
367H00000X
Anesthesiologist Assistant
Primary
—
—
Other
Enumeration date
04/02/2018
Last updated
03/18/2026
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