Provider Demographics
NPI:1811034879
Name:BISHOP, ANN ARDARY (PT)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:ARDARY
Last Name:BISHOP
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22180 PONTIAC TRL STE E
Mailing Address - Street 2:
Mailing Address - City:SOUTH LYON
Mailing Address - State:MI
Mailing Address - Zip Code:48178-9097
Mailing Address - Country:US
Mailing Address - Phone:248-446-0155
Mailing Address - Fax:248-446-0177
Practice Address - Street 1:22180 PONTIAC TRL STE E
Practice Address - Street 2:
Practice Address - City:SOUTH LYON
Practice Address - State:MI
Practice Address - Zip Code:48178
Practice Address - Country:US
Practice Address - Phone:248-446-0155
Practice Address - Fax:248-446-0177
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501003514225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0H73728OtherBCBS PIN
MI1811034879Medicaid
MI7543420OtherAETNA
MI0H20222OtherBLUE CROSS BLUE SHIELD
MIP00100555OtherMEDICARE RAILROAD
MI500573OtherCARE CHOICES
MI16869OtherM-CARE