Individual
DR. ROBERT A FISHMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
21000 E 12 MILE RD, SUITE 111, SAINT CLAIR SHORES, MI 48081-1116
(586) 779-7610
Mailing address
21000 E 12 MILE RD, STE 111, ST CLAIR SHORES, MI 48081
(586) 779-7610
(576) 445-2523
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
RF041043
MI
207YP0228X
Pediatric Otolaryngology Physician
Primary
RF041043
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040008563
RAILROAD MEDICARE
—
01
—
040E06192
BLUE SHIELD GROUP
MI
01
—
0500323
BLUE CARE NETWORK
—
01
—
101764
CARE CHOICES
—
01
—
103994
GREAT LAKES HEALTH
—
05
—
1433910
—
MI
01
—
2326702002
CIGNA
—
01
—
44033233
AETNA
—
01
—
C5083
MCAR
—
01
—
D91373
HEALTH ALLIANCE PLAN
—
Enumeration date
09/29/2006
Last updated
05/22/2019
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