David Robert Charles Fisher, D.O.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

066368 Issued in GA

Practice address

4106 Columbia Rd
Suite 103
Martinez, GA 30907-1450

Phone

(706) 863-1440

Fax

(706) 863-5418

NPI assigned

Jun 25, 2008

Last updated

Nov 23, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Covenant Multispecialty Group

  dba Covenant Pediatrics

  • Pediatrics Physician
  • Martinez, GA
  • NPI 1942376918
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1214352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322006400000",
    "number": "1346402088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4106 COLUMBIA RD",
            "address_2": "SUITE 103",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309071450",
            "telephone_number": "706-863-1440",
            "fax_number": "706-863-5418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4106 COLUMBIA RD",
            "address_2": "SUITE 103",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309071450",
            "telephone_number": "706-863-1440",
            "fax_number": "706-863-5418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "DAVID",
        "middle_name": "ROBERT CHARLES",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-25",
        "last_updated": "2011-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "066368",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003107241A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angiselis Lourdes Feliciano Martell
• Fenixx in Flow
• Tiffany Few
• Caroline Fickling, OTR/L
• First Focus Faith, LLC
• Nicolette Fleck
• Sherry Fleming, R.N., PH.D.
• Breante' Flournoy
• Sherita Latoya Flournoy, PHARM D
• Elizabeth Forbes

• Pediatrics Physician in Martinez, GA
• Providers in Martinez, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.