Provider Demographics
NPI:1902978331
Name:FISHER, MICHAEL E (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:E
Last Name:FISHER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1702 US HIGHWAY 70 E
Mailing Address - Street 2:SUITE E
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28560-6829
Mailing Address - Country:US
Mailing Address - Phone:252-638-3600
Mailing Address - Fax:
Practice Address - Street 1:1702 US HIGHWAY 70 E
Practice Address - Street 2:SUITE E
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28560-6829
Practice Address - Country:US
Practice Address - Phone:252-638-3600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC47641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC92723OtherBLUE CROSS BLUE SHIELD
NC8992723Medicaid
NC406841OtherUNITED CONCORIDA