Provider Demographics
NPI:1255399705
Name:FISHER, STEPHEN I (MD)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:I
Last Name:FISHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:600 GRESHAM DR
Mailing Address - Street 2:SENTARA NORFOLK GENERAL HOSPITAL PATH DEPT
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23507-1904
Mailing Address - Country:US
Mailing Address - Phone:757-388-3221
Mailing Address - Fax:757-388-3799
Practice Address - Street 1:600 GRESHAM DR
Practice Address - Street 2:SENTARA NORFOLK GENERAL HOSPITAL PATH DEPT
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23507-1904
Practice Address - Country:US
Practice Address - Phone:757-388-3221
Practice Address - Fax:757-388-3799
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2010-11-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101234019207ZH0000X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZH0000XAllopathic & Osteopathic PhysiciansPathologyHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010001471Medicaid
VA010001471Medicaid
VAA101116Medicare PIN