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NPI Code Detail

MEDICARE: TROY W BISHOP MD LLC

MEDICARE: TROY W BISHOP MD LLC
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
1207R00000XInternal Medicine Physician

General Provider Information

NPI Number : 1790429785
Entity Type Code : Organization
Provider Name (Legal Business Name) : TROY W BISHOP MD LLC
Provider Business Mailing Address
First Line : 9417 BROADVIEW RD
Second Line :
City : BROADVIEW HEIGHTS
State : OH
Zip : 44147-2307
Country : US
Telephone Number : 440-545-2272
Fax Number : 440-545-5645
Provider Business Practice Location Address
First Line : 9417 BROADVIEW RD
Second Line :
City : BROADVIEW HEIGHTS
State : OH
Zip : 44147-2307
Country : US
Telephone Number : 440-545-2272
Fax Number : 440-545-5645
Authorized Official
Title or Position : PHYSICIAN
Name : DR. TROY WILLIAM BISHOP
Credential : MD
Telephone Number : 440-545-2272
Provider Enumeration Date : 04/25/2022
Last Update Date : 04/25/2022

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