Healthcare Provider Details

I. General information

NPI: 1639606619
Provider Name (Legal Business Name): DAVID MATHEW BISHOP DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2017
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

440 E STATE ST
ALLIANCE OH
44601-4910
US

IV. Provider business mailing address

440 E STATE ST
ALLIANCE OH
44601-4910
US

V. Phone/Fax

Practice location:
  • Phone: 330-821-6438
  • Fax: 330-821-8433
Mailing address:
  • Phone: 330-821-6438
  • Fax: 330-821-8433

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number36.003950
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number36.003950
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: