Individual
MR. DANIEL S BISHTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
2200 LAKE AVE, SUITE 260, FORT WAYNE, IN 46805-5397
(260) 424-0411
Mailing address
3506 SUN VALLEY DR, FORT WAYNE, IN 46804-6616
(260) 580-3927
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34001383A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000660153
ANTHEM BCBS
IN
01
—
061904000
MAGELLAN
IN
01
—
7362096
AETNA
IN
01
—
84585
CIGNA
—
Enumeration date
05/28/2005
Last updated
08/13/2013
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