Individual
CRYSTAL M BISHOP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1330 BOILING SPRINGS RD STE 1600, SPARTANBURG, SC 29303-4219
(864) 582-6396
(864) 582-1608
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
2882
SC
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P02302275
RAILROAD MEDICARE
SC
Enumeration date
11/15/2017
Last updated
12/01/2022
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