Provider Demographics
NPI:1700888336
Name:BISHOP, ROBERT HUFFMAN (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:HUFFMAN
Last Name:BISHOP
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8424 NAAB RD
Mailing Address - Street 2:#3 J
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-5918
Mailing Address - Country:US
Mailing Address - Phone:317-872-7396
Mailing Address - Fax:317-879-8328
Practice Address - Street 1:8424 NAAB RD
Practice Address - Street 2:#3 J
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-5918
Practice Address - Country:US
Practice Address - Phone:317-872-7396
Practice Address - Fax:317-879-8328
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01024430A207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1000083770Medicaid
C24256Medicare UPIN
IN1000083770Medicaid