Basic Information
| Provider Information | |||||||||
| NPI: | 1871793331 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FISCHER | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
| MiddleName: | MATTHEW | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 DEACONESS RD WEST CC2 | ||||||||
| Address2: | DEPT OF EMERGENCY MEDICINE - BETH ISRAEL DEACONESS | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02215 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1 DEACONESS RD, WEST CC2 | ||||||||
| Address2: | DEPT OF EMERGENCY MEDICINE, BETH ISRAEL DEACONESS | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6177542323 | ||||||||
| FaxNumber: | 6177542350 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/23/2007 | ||||||||
| LastUpdateDate: | 11/19/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 232732 | MA | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | J41993 | 01 | MA | BCBS | OTHER | 2137275 | 05 | MA | MEDICAID | 496347 | 01 | MA | TUFTS | OTHER | AA95716 | 01 | MA | HARVARD PILGRIM | OTHER |