Edward J. Fisher, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

25642 Issued in MN

Practice address

12720 Bass Lake Rd
Maple Grove, MN 55369-6307

Phone

(763) 559-2861

Fax

(763) 559-1338

NPI assigned

Mar 3, 2006

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 Medicine

State licenses

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

{
    "created_epoch": "1141344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316649600000",
    "number": "1740257187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12720 BASS LAKE RD",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553696307",
            "telephone_number": "763-559-2861",
            "fax_number": "763-559-1338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12720 BASS LAKE RD",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553696307",
            "telephone_number": "763-559-2861",
            "fax_number": "763-559-1338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "EDWARD",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-03",
        "last_updated": "2011-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "25642",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "435800700",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• First Choice Residential LLC
• Fischer Vision PC
• Alexandra M Fischer, PA-C
• Londa Lea Fischer, O.D.
• Morgan Fischer
• Sheryl Ann Fisher, MSW, LICSW
• Jacob Fixell, DPT
• Catrina Fjerstad, DPT
• Melinda Marie Fjosne, PT, DPT
• Sara Elizabeth Flaagan

• Pediatrics Physician in Maple Grove, MN
• Providers in Maple Grove, MN by specialty
• Pediatrics Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 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.