Provider Demographics
NPI:1144296757
Name:FISHER, GARY P (MD)
Entity type:Individual
Prefix:DR
First Name:GARY
Middle Name:P
Last Name:FISHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:5530 WISCONSIN AVE
Mailing Address - Street 2:SUITE 730
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-4404
Mailing Address - Country:US
Mailing Address - Phone:301-656-3334
Mailing Address - Fax:301-654-1924
Practice Address - Street 1:5530 WISCONSIN AVE
Practice Address - Street 2:SUITE 730
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-4404
Practice Address - Country:US
Practice Address - Phone:301-656-3334
Practice Address - Fax:301-654-1924
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0013818207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD125151S12Medicare PIN
DCC61971Medicare UPIN
DC680035Medicare ID - Type Unspecified