Doctor Name: | BISHOY T SAMUEL |
NPI Number: | 1659506624 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 34453 |
Business Practice Address: | 515 N Miranda Ave Georgiana, AL - 360334519 |
Business Phone Number: | 3343762205 |
Business Fax Number: | |
Mailing Address: | 515 N Miranda Ave, GEORGIANA |
State: | AL |
Postal Code: | 360334519 |
Phone Number: | 3343762205 |
Fax Number: | |
NPI Enumeration Date: | 05/20/2009 |
NPI Last Update Date: | 09/11/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 34453 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |