Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 200401548 | NC |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 200401548 | NC |
NPI | 1629066212 |
---|---|
Provider Name | Dr. Delina Harsha Bishop |
First Address | Mooresville, NC 28115-8308 |
Second Address | Mooresville, NC 28117-8192 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/10/2005 |
Last Update Date | 04/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5912020 | (05) | NC |