Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | 4301070170 | MI |
NPI | 1013958248 |
---|---|
Provider Name | Dr. James Bishop JR. |
First Address | Farmington, MI 48335-3128 |
Second Address | Southfield, MI 48075-4818 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H21837 | (02) | MI |
JB070170 | BC/BS OF MICHIGAN (01) | MI |