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NPI Code Detail

MEDICARE: NICHOLAS HOLDAWAY BISHOP MD, PHD

MEDICARE: NICHOLAS HOLDAWAY BISHOP MD, PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208M00000XHospitalist Physician12129849-1205UT

General Provider Information

NPI Number : 1568969772
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICHOLAS HOLDAWAY BISHOP MD, PHD
Provider Business Mailing Address
First Line : PO BOX 27128
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84127-0128
Country : US
Telephone Number : 801-357-7291
Fax Number :
Provider Business Practice Location Address
First Line : 1034 N 500 W
Second Line :
City : PROVO
State : UT
Zip : 84604-3380
Country : US
Telephone Number : 801-357-7291
Fax Number : 801-357-3854
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2018
Last Update Date : 06/03/2026

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