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General NPI Number Information
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NPI Number | 1346251527
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Entity Type | Individual
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Provider Name | MICHAEL E BISHOP DC, MPAS, MBA, PA-C
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Gender | Male
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Dates
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Enumeration Date | 08/11/2006
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Last Update Date | 02/08/2024
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Provider Practice Location Address
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Address Line | 2471 310TH AVENUE
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City | MAHNOMEN
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State | MN
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Zip | 56557
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Country | US
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Telephone | 218-935-2238
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Fax | 218-935-5085
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Provider Business Mailing Address
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Address Line | 40520 COUNTY HIGHWAY 34
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City | OGEMA
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State | MN
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Zip | 56569-9612
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Country | US
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Telephone | 218-983-4300
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Fax | 218-983-6307
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 10779
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 694
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License Number State | ND
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Taxonomy #3
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 4088
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License Number State | MN
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Taxonomy #4
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 1435
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License Number State | MN
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Taxonomy #5
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PAC0588
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License Number State | ND
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