Individual
KEITH R FISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 MEDICAL CENTER DRIVE, DHMC DEPT OF SLEEP MEDICINE, LEBANON, NH 03756-0001
(603) 650-3630
Mailing address
1 MEDICAL CENTER DRIVE, DHMC DEPT OF SLEEP MEDICINE, LEBANON, NH 03756-0001
(603) 650-3630
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
1382969
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010038296CT03
ANTHEM BCBS
—
01
—
2V5140
HEALTHNET
—
01
—
36549485
TRI-CARE
—
Enumeration date
08/31/2006
Last updated
10/07/2016
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