Provider Demographics
NPI:1346468659
Name:BISHOP-BARTOLOMEI, KELLY K (MD)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:K
Last Name:BISHOP-BARTOLOMEI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KELLY
Other - Middle Name:K
Other - Last Name:BISHOP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3073 WHITE MOUNTAIN HWY
Mailing Address - Street 2:
Mailing Address - City:NORTH CONWAY
Mailing Address - State:NH
Mailing Address - Zip Code:03860-7101
Mailing Address - Country:US
Mailing Address - Phone:603-356-4949
Mailing Address - Fax:
Practice Address - Street 1:3073 WHITE MOUNTAIN HWY
Practice Address - Street 2:
Practice Address - City:NORTH CONWAY
Practice Address - State:NH
Practice Address - Zip Code:03860-7101
Practice Address - Country:US
Practice Address - Phone:603-356-4949
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH16439208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1346468659OtherFALLON COMMUNITY HEALTH PLAN
MAAA180984OtherHARVARD PILGRIM HEALTH PLAN
MA756631OtherTUFTS HEALTH PLAN
MA001705001Medicare PIN
MA110086050AMedicaid
MA49330OtherHEALTH NEW ENGLAND
MA045218OtherCONNECTICARE
MAJ47282OtherBLUE CROSS AND BLUE SHIELD OF MASS LEGACY NUMBER
MAI73558Medicare UPIN