Provider Demographics
NPI:1346218112
Name:BISK, PENNY L (MD)
Entity Type:Individual
Prefix:DR
First Name:PENNY
Middle Name:L
Last Name:BISK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7601 BARNUM RD
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-2072
Mailing Address - Country:US
Mailing Address - Phone:301-469-8873
Mailing Address - Fax:
Practice Address - Street 1:10301 GEORGIA AVE
Practice Address - Street 2:SUITE #301
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-5020
Practice Address - Country:US
Practice Address - Phone:301-754-1950
Practice Address - Fax:301-754-1965
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0025085207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDB94787Medicare UPIN