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Individual

STEVEN J. FISHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
44 S MAIN ST, RANDOLPH, VT 05060-1381
(802) 728-2345
(802) 728-2613
Mailing address
44 S MAIN ST, RANDOLPH, VT 05060-1381
(802) 728-2345
(802) 728-2613

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
011282
ME
207P00000X
Emergency Medicine Physician
Primary
042-0007233
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0006637
VT
01
001015
ANTHEM
ME
01
010453642
GREATWEST/ONE HEALTH
ME
01
1922181635
TRICARE
ME
05
268340099
ME
01
3009259
MVP HEALTH CARE
VT
01
5046643
AETNA
ME
01
930011982
RR MEDICARE
ME
01
D78610
HARVARD PILGRIM
ME
Enumeration date
10/24/2006
Last updated
04/13/2010
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