Provider Demographics
NPI:1467944348
Name:BISHOP, CIA MERIN (MD)
Entity Type:Individual
Prefix:DR
First Name:CIA
Middle Name:MERIN
Last Name:BISHOP
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CIA
Other - Middle Name:MERIN
Other - Last Name:PANICKER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:593 EDDY ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-4923
Mailing Address - Country:US
Mailing Address - Phone:401-444-4471
Mailing Address - Fax:401-444-7574
Practice Address - Street 1:593 EDDY ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-4923
Practice Address - Country:US
Practice Address - Phone:401-444-4471
Practice Address - Fax:401-444-7574
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-05
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILP04326208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics