Provider Demographics
NPI:1255342077
Name:BISHOP, ROBERT J (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:J
Last Name:BISHOP
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1800 TOWN CENTER DR
Mailing Address - Street 2:STE. 420
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190-3215
Mailing Address - Country:US
Mailing Address - Phone:703-437-0400
Mailing Address - Fax:703-437-9435
Practice Address - Street 1:1800 TOWN CENTER DR
Practice Address - Street 2:STE. 420
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-3215
Practice Address - Country:US
Practice Address - Phone:703-437-0400
Practice Address - Fax:703-437-9435
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2015-01-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA01010394932084P0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0101039493OtherSTATE LICENSE