Provider Demographics
NPI:1447699046
Name:FISHER, ANGELA COWART (MD)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:COWART
Last Name:FISHER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:ELIZABETH
Other - Last Name:COWART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:302 MEDICAL PARK DR STE 211
Mailing Address - Street 2:
Mailing Address - City:WALTERBORO
Mailing Address - State:SC
Mailing Address - Zip Code:29488-5749
Mailing Address - Country:US
Mailing Address - Phone:843-549-9568
Mailing Address - Fax:843-549-1530
Practice Address - Street 1:400 CONSTANCE ST
Practice Address - Street 2:
Practice Address - City:WALTERBORO
Practice Address - State:SC
Practice Address - Zip Code:29488-2710
Practice Address - Country:US
Practice Address - Phone:843-549-9568
Practice Address - Fax:843-549-1530
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-18
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDP28799207V00000X
SCMD51227207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty