Provider Demographics
NPI:1144240060
Name:BISHOP, NORMAN L (DC)
Entity Type:Individual
Prefix:
First Name:NORMAN
Middle Name:L
Last Name:BISHOP
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8988 UNIVERSITY BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406-9183
Mailing Address - Country:US
Mailing Address - Phone:843-764-3663
Mailing Address - Fax:843-764-3664
Practice Address - Street 1:8988 UNIVERSITY BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-9183
Practice Address - Country:US
Practice Address - Phone:843-764-3663
Practice Address - Fax:843-764-3664
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1098111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCCH1098Medicaid
SC570853724OtherTAX IDENTIFICATION NUMBER
SCCH1098Medicaid