Provider Demographics
NPI:1629257167
Name:KATHLEEN BIS, M.D., PLLC
Entity Type:Organization
Organization Name:KATHLEEN BIS, M.D., PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN AND PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:202-293-4100
Mailing Address - Street 1:2440 M ST NW
Mailing Address - Street 2:SUITE 318
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20037-1404
Mailing Address - Country:US
Mailing Address - Phone:202-293-4100
Mailing Address - Fax:202-293-2314
Practice Address - Street 1:2440 M ST NW
Practice Address - Street 2:SUITE 318
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-1404
Practice Address - Country:US
Practice Address - Phone:202-293-4100
Practice Address - Fax:202-293-2314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-01
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC6685207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCC87840Medicare UPIN