1477739498 NPI number — ANDREW R. BISHOP, M.D., P.C

Table of content: (NPI 1477739498)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477739498 NPI number — ANDREW R. BISHOP, M.D., P.C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ANDREW R. BISHOP, M.D., P.C
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1477739498
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/24/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
136 LINDEN DR STE 104
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WINCHESTER
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22601-6900
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-678-3588
Provider Business Mailing Address Fax Number:
540-678-9025

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
107 WEST FEDERAL STREET
Provider Second Line Business Practice Location Address:
SUITE 9
Provider Business Practice Location Address City Name:
MIDDLEBURG
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
20117
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-687-3390
Provider Business Practice Location Address Fax Number:
540-687-3544
Provider Enumeration Date:
01/22/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BISHOP
Authorized Official First Name:
ANDREW
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
404-352-8156

Provider Taxonomy Codes

  • Taxonomy code: 207X00000X , with the licence number:  029142 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1477739498 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".