Provider Demographics
NPI:1528557543
Name:HWMD MEDICAL PROFESSIONALS PLLC
Entity Type:Organization
Organization Name:HWMD MEDICAL PROFESSIONALS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DELINA
Authorized Official - Middle Name:HARSHA
Authorized Official - Last Name:BISHOP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:704-664-1275
Mailing Address - Street 1:478 WILLIAMSON RD, UNIT 202B
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-8192
Mailing Address - Country:US
Mailing Address - Phone:704-664-1275
Mailing Address - Fax:704-380-0986
Practice Address - Street 1:478 WILLIAMSON RD, UNIT 202B/203C
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-8192
Practice Address - Country:US
Practice Address - Phone:704-664-1275
Practice Address - Fax:704-380-0986
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-04
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207Q00000X, 207QB0002X, 207QH0002X, 208VP0000X
NC261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207QB0002XAllopathic & Osteopathic PhysiciansFamily MedicineObesity MedicineGroup - Multi-Specialty
No207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative MedicineGroup - Multi-Specialty
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty