Provider Demographics
NPI:1437323292
Name:BISBE, MARISSA LOPEZ (DO)
Entity Type:Individual
Prefix:DR
First Name:MARISSA
Middle Name:LOPEZ
Last Name:BISBE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:690 CANTON ST
Mailing Address - Street 2:STE 325
Mailing Address - City:WESTWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02090-2324
Mailing Address - Country:US
Mailing Address - Phone:781-407-7713
Mailing Address - Fax:781-407-0998
Practice Address - Street 1:27 WISTERIA ST
Practice Address - Street 2:UNIT 4
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-4541
Practice Address - Country:US
Practice Address - Phone:617-669-6268
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-14
Last Update Date:2016-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA229655207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology