Individual
MR. MICHAEL G BISSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPO, FAAOP
Contact information
Practice address
3680 WESTGATE CENTER CIRCLE, WINSTON SALEM, NC 27103-2935
(336) 768-1933
(336) 768-4869
Mailing address
2800 SAINT LEOS STREET, GREENSBORO, NC 27405-3382
(336) 621-9500
(336) 621-0980
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
—
—
222Z00000X
Orthotist
Primary
CP001225
NC
224P00000X
Prosthetist
CP001225
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0487N
BCBS
NC
01
—
2021053
AETNA PROVIDER NUMBER
NC
01
—
32953
PARTNERS MEDICARE CHOICE
NC
01
—
4496224
PROVIDER # NON HMO AETNA
NC
05
—
7703164
—
NC
05
—
7795063
—
NC
05
—
9110925
—
NC
01
—
A9348
MEDCOST
NC
Enumeration date
10/12/2005
Last updated
08/26/2010
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