Provider Demographics
NPI:1053427690
Name:FISCHER, GARY H (MD)
Entity type:Individual
Prefix:DR
First Name:GARY
Middle Name:H
Last Name:FISCHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:14690 SPRING HILL DR STE 305
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609-8102
Mailing Address - Country:US
Mailing Address - Phone:352-277-5348
Mailing Address - Fax:352-606-2857
Practice Address - Street 1:5350 SPRING HILL DR
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34606-4562
Practice Address - Country:US
Practice Address - Phone:352-688-8116
Practice Address - Fax:352-686-9477
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME59935207Q00000X, 208D00000X, 208M00000X
GA057804208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAP00361218OtherRR MEDICARE
SCG57804Medicaid
GA808238309IMedicaid
GAE76382Medicare UPIN
SCG57804Medicaid