Doctor Name: | DR. MARC JUDAH FISHMAN |
NPI Number: | 1649317264 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | D0038913 |
Business Practice Address: | 3800 Frederick Avenue Na Baltimore, MD - 212293618 |
Business Phone Number: | 4102331400 |
Business Fax Number: | 4102335583 |
Mailing Address: | 3800 Frederick Avenue, Na BALTIMORE |
State: | MD |
Postal Code: | 21229 |
Phone Number: | 4102331400 |
Fax Number: | 4102335583 |
NPI Enumeration Date: | 01/31/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2084A0401X |
License Number: | D0038913 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | MD |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Psychiatry & Neurology |
Taxonomy Specialization: | Addiction Medicine |
Taxonomy Definition: | A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |