Provider Demographics
NPI:1386162881
Name:FREDERICK M FISCHER P C
Entity type:Organization
Organization Name:FREDERICK M FISCHER P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:M
Authorized Official - Last Name:FISCHER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:314-962-3316
Mailing Address - Street 1:212 GLEN RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63119-2403
Mailing Address - Country:US
Mailing Address - Phone:314-962-3316
Mailing Address - Fax:314-962-3316
Practice Address - Street 1:16 N GORE AVE STE 209
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63119-2315
Practice Address - Country:US
Practice Address - Phone:314-962-3316
Practice Address - Fax:314-962-3316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-05
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty