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General NPI Number Information
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NPI Number | 1760444186
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Entity Type | Individual
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Provider Name | HANY M BISHARA MD
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Gender | Male
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Dates
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Enumeration Date | 04/03/2006
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Last Update Date | 02/22/2008
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Provider Practice Location Address
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Address Line | 833 CAMPBELL HILL ST SUITE 111
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City | MARIETTA
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State | GA
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Zip | 30060
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Country | US
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Telephone | 770-424-7800
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Fax | 770-426-8572
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Provider Business Mailing Address
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Address Line | PO BOX 60280 MCKESSON CORP
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City | CHARLESTON
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State | SC
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Zip | 29419-0280
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Country | US
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Telephone | 843-569-4020
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Fax | 770-237-4980
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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 | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 032874
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License Number State | GA
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