Provider Demographics
NPI:1922093475
Name:BISSELL, MARION COLMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:MARION
Middle Name:COLMAN
Last Name:BISSELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6355 WALKER LN
Mailing Address - Street 2:#408
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22310-3245
Mailing Address - Country:US
Mailing Address - Phone:703-719-5901
Mailing Address - Fax:703-719-9629
Practice Address - Street 1:6355 WALKER LN
Practice Address - Street 2:#408
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22310-3245
Practice Address - Country:US
Practice Address - Phone:703-719-5901
Practice Address - Fax:703-719-9629
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2014-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101042192207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6253750Medicaid
VA6253750Medicaid
E53264Medicare UPIN