Provider Demographics
NPI:1699110684
Name:FITCH, DAVID NATHANIEL (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:NATHANIEL
Last Name:FITCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 E GUMP RD
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46845-9358
Mailing Address - Country:US
Mailing Address - Phone:260-433-7747
Mailing Address - Fax:
Practice Address - Street 1:425 FARRELL CT
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45233-1677
Practice Address - Country:US
Practice Address - Phone:513-794-5600
Practice Address - Fax:513-281-1908
Is Sole Proprietor?:No
Enumeration Date:2013-05-03
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35127954207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology