Provider Demographics
NPI:1477739498
Name:ANDREW R. BISHOP, M.D., P.C
Entity Type:Organization
Organization Name:ANDREW R. BISHOP, M.D., P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:BISHOP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-352-8156
Mailing Address - Street 1:136 LINDEN DR STE 104
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-6900
Mailing Address - Country:US
Mailing Address - Phone:540-678-3588
Mailing Address - Fax:540-678-9025
Practice Address - Street 1:107 WEST FEDERAL STREET
Practice Address - Street 2:SUITE 9
Practice Address - City:MIDDLEBURG
Practice Address - State:VA
Practice Address - Zip Code:20117
Practice Address - Country:US
Practice Address - Phone:540-687-3390
Practice Address - Fax:540-687-3544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-22
Last Update Date:2009-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA029142207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1477739498Medicaid
VA1477739498Medicaid
DC144625Medicare PIN
VAC10389Medicare PIN
GA20BBDCKMedicare PIN