Individual
MR. MICHAEL ALEXANDER FISHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
7950 N SHADELAND AVE STE 200, INDIANAPOLIS, IN 46250-2692
(317) 849-3517
(317) 849-6397
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05008694A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000505373
ANTHEM/BCBS
IN
01
—
1538211578
GROUP NPI
IN
05
—
200848350A
—
IN
05
—
200848410
—
IN
01
—
DF7914
RAILROAD MEDICARE ID
IN
Enumeration date
11/13/2006
Last updated
06/22/2021
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