MEDICARE: SIDNEY BISHOP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	6852094402	MI

General Provider Information

NPI Number	:	1134635212
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SIDNEY BISHOP

Provider Business Mailing Address
First Line	:	22170 W 9 MILE RD
Second Line	:
City	:	SOUTHFIELD
State	:	MI
Zip	:	48033-6007
Country	:	US
Telephone Number	:	248-372-6800
Fax Number	:

Provider Business Practice Location Address
First Line	:	22170 W 9 MILE RD
Second Line	:
City	:	SOUTHFIELD
State	:	MI
Zip	:	48033-6007
Country	:	US
Telephone Number	:	248-372-6800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/27/2017
Last Update Date	:	04/16/2026

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Directions to “ SIDNEY BISHOP ” Practice Location

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