Individual
JUSTIN AVERY BISHOP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
600 N WOLFE ST, BALTIMORE, MD 21205-2101
(410) 955-3580
(410) 614-7726
Mailing address
PO BOX 64478, BALTIMORE, MD 21264-4478
(410) 955-8116
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
D70023
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
035296900
—
MD
Enumeration date
01/17/2007
Last updated
02/04/2013
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