Provider Demographics
NPI:1992789598
Name:FISHER, ROBERT E (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:E
Last Name:FISHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:7951 E MAPLEWOOD AVE
Mailing Address - Street 2:STE 300
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-4723
Mailing Address - Country:US
Mailing Address - Phone:303-930-7800
Mailing Address - Fax:
Practice Address - Street 1:2030 MTN VIEW DR
Practice Address - Street 2:STE 210
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501
Practice Address - Country:US
Practice Address - Phone:303-684-1900
Practice Address - Fax:303-684-1925
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2011-07-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO40240207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO68472218Medicaid
CO68472218Medicaid
COC802903Medicare PIN