Provider Demographics
NPI:1053801753
Name:FISHEL, HOWELL ROSS (MD)
Entity type:Individual
Prefix:
First Name:HOWELL
Middle Name:ROSS
Last Name:FISHEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 HARMON AVENUE
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32401
Mailing Address - Country:US
Mailing Address - Phone:850-819-4989
Mailing Address - Fax:601-984-5110
Practice Address - Street 1:2407 RUTH HENTZ AVENUE
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405
Practice Address - Country:US
Practice Address - Phone:850-522-5022
Practice Address - Fax:601-984-5110
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-17
Last Update Date:2023-07-26
Deactivation Date:2023-06-23
Deactivation Code:
Reactivation Date:2023-07-25
Provider Licenses
StateLicense IDTaxonomies
FLME162052208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty