Individual
PAUL JORDAN FISHMAN
Active
Individual
PAUL JORDAN FISHMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
17709
CO
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
17709
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01177096
—
CO
01
—
110086492
RRW MEDICARE
CO
Enumeration date
08/24/2006
Last updated
10/16/2012
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