Provider Demographics
NPI:1194739458
Name:BISHOP, WILLIAM F (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:F
Last Name:BISHOP
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2717 SUNRISE AVE
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350-2438
Mailing Address - Country:US
Mailing Address - Phone:209-525-8254
Mailing Address - Fax:
Practice Address - Street 1:1524 MCHENRY AVE
Practice Address - Street 2:SUITE 315
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-4500
Practice Address - Country:US
Practice Address - Phone:209-557-6200
Practice Address - Fax:209-557-6239
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ13550207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
D36566Medicare UPIN
ZMD13550Medicare ID - Type Unspecified