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General NPI Number Information
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NPI Number | 1710662960
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Entity Type | Individual
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Provider Name | MELANIE JOYCE BISH FNP-C
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Gender | Female
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Dates
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Enumeration Date | 06/15/2023
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Last Update Date | 12/20/2023
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Provider Practice Location Address
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Address Line | 4660 WILKENS AVE STE 205
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City | BALTIMORE
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State | MD
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Zip | 21229-4846
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Country | US
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Telephone | 410-650-4121
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Fax |
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Provider Business Mailing Address
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Address Line | 6221 FREE STONE CT
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City | COLUMBIA
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State | MD
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Zip | 21045-4401
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Country | US
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Telephone | 850-876-9664
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Fax |
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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 | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | AC005587
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AC005587
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License Number State | MD
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