Healthcare Provider Details

I. General information

NPI: 1750343745
Provider Name (Legal Business Name): KRISTIN BISHOP BAYUK PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTIN NICOLE BISHOP PA-C

II. Dates (important events)

Enumeration Date: 04/05/2006
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2306 HARRINGTON ST STE 1
NEWBERRY SC
29108-3088
US

IV. Provider business mailing address

PO BOX 9235
MORGANTOWN WV
26506-9235
US

V. Phone/Fax

Practice location:
  • Phone: 803-260-9123
  • Fax:
Mailing address:
  • Phone: 304-598-4051
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA9103493
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number1898
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: