Individual
TODD M BISHOP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
80 SOUTH MAIN ST, MIDDLETOWN, CT 06457
(860) 358-6878
Mailing address
80 SOUTH MAIN ST, MIDDLETOWN, CT 06457
(860) 358-6878
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
043002
CT
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
229835
MA
207RP1001X
Pulmonary Disease Physician
Primary
229835
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2102358
—
MA
01
—
43002
CT LICENSE 43002
CT
Enumeration date
06/17/2005
Last updated
10/15/2010
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