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Elliot K Fishman

Radiology

Allopathic & Osteopathic Physicians

600 N Wolfe St, Baltimore, MD 21287-0005

PECOS Enrollment

This provider is enrolled in PECOS as ELLIOT FISHMAN.

Based on the most recent information from CMS, provider Elliot K Fishman is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 5 days ago.

Profile Details

Provider ID
1174566517
Provider Type
Individual
Full Name
Fishman, Elliot K
Credential
M.D.

Gender
Male
Sole Proprietor
No
Enumeration Date
6/14/2006
Last Updated
2/6/2013

Contact Information

Practice Location

600 N Wolfe St, Baltimore, MD 21287-0005

(410) 955-6500

Unlisted Fax

Mailing Location

PO Box 64358, Baltimore, MD 21264-4358

(410) 955-6500

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 2085R0202X Primary	Description Radiology Allopathic & Osteopathic Physicians	License D20945 Maryland

Provider Identifiers

ID	Description	Issuer
ID 317611800	Description Medicaid	Issuer Unlisted Maryland

Elliot K Fishman

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Takhtani, Deepak

Desai, Neal

Wolfman, Darcy Jennifer

Siegelman, Stanley

Ambinder, Emily Bayle Mcintosh

Charkhchi, Paniz

Kovacich, Joseph

Tank, Dharmesh

Esterson, Yonah Baruch

Trapeni, Joanne Marie