Provider Demographics
NPI:1992728539
Name:FISHER, WILLIAM J (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:J
Last Name:FISHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4037 ARBOR LN STE D
Mailing Address - Street 2:
Mailing Address - City:NEW PALESTINE
Mailing Address - State:IN
Mailing Address - Zip Code:46163-9269
Mailing Address - Country:US
Mailing Address - Phone:317-861-7125
Mailing Address - Fax:317-861-7141
Practice Address - Street 1:4037 ARBOR LN STE D
Practice Address - Street 2:
Practice Address - City:NEW PALESTINE
Practice Address - State:IN
Practice Address - Zip Code:46163-9269
Practice Address - Country:US
Practice Address - Phone:317-861-7125
Practice Address - Fax:317-861-7141
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2024-08-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN01055043A208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200444730Medicaid
IN000000321893OtherANTHEM
IN214100AMedicare PIN