Provider Demographics
NPI:1407828650
Name:Y.B. BISHAI MD PC
Entity type:Organization
Organization Name:Y.B. BISHAI MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YOUSEF
Authorized Official - Middle Name:
Authorized Official - Last Name:BISHAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-266-2780
Mailing Address - Street 1:28043 HOOVER RD
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48093-4167
Mailing Address - Country:US
Mailing Address - Phone:586-751-1490
Mailing Address - Fax:586-751-1492
Practice Address - Street 1:28043 HOOVER RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48093-4167
Practice Address - Country:US
Practice Address - Phone:568-751-1490
Practice Address - Fax:586-751-1492
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-02
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0N98010Medicare PIN