Provider Demographics
NPI:1679655708
Name:BISHOP, MONICA (OD)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:BISHOP
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1950 OLD GALLOWS RD
Mailing Address - Street 2:SUITE 520
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3990
Mailing Address - Country:US
Mailing Address - Phone:703-847-8899
Mailing Address - Fax:703-991-0514
Practice Address - Street 1:9930 SOWDER VILLAGE SQ
Practice Address - Street 2:SUITE 220
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20109-5464
Practice Address - Country:US
Practice Address - Phone:703-368-2121
Practice Address - Fax:703-368-3376
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2018-01-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0618001028152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist