Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 20005 | MN |
NPI | 1003094566 |
---|---|
Provider Name | James Raymond Bishop |
First Address | Edina, MN 55436-1148 |
Second Address | Edina, MN 55435-2104 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2008 |
Last Update Date | 07/02/2008 |