Provider Demographics
NPI:1104634625
Name:FISHER, RODNEY EDWARD
Entity type:Individual
Prefix:
First Name:RODNEY
Middle Name:EDWARD
Last Name:FISHER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1303 C ST SE # 124409
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-2346
Mailing Address - Country:US
Mailing Address - Phone:771-333-9930
Mailing Address - Fax:
Practice Address - Street 1:1303 C ST SE # 124409
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-2346
Practice Address - Country:US
Practice Address - Phone:771-333-9930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-30
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider