Basic Information
| Provider Information | |||||||||
| NPI: | 1881071579 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FISCHER | ||||||||
| FirstName: | CHARLES | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 13900 SHELTER MANOR DR | ||||||||
| Address2: | |||||||||
| City: | HAYMARKET | ||||||||
| State: | VA | ||||||||
| PostalCode: | 201692447 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7037280417 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2150 PENNSYLVANIA AVE NW | ||||||||
| Address2: | THE GW MEDICAL FACULTY ASSOCITATES | ||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200373201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2027413000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/01/2015 | ||||||||
| LastUpdateDate: | 09/30/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 09/30/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 036152213 | IL | Y | Allopathic & Osteopathic Physicians | Anesthesiology | 390200000X | DC | N | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.