Individual
HANY M BISHARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
833 CAMPBELL HILL ST, SUITE 111, MARIETTA, GA 30060
(770) 424-7800
(770) 426-8572
Mailing address
PO BOX 60280, MCKESSON CORP, CHARLESTON, SC 29419-0280
(843) 569-4020
(770) 237-4980
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
032874
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00531572A
—
GA
01
—
220020959
RAILROAD MEDICARE
GA
01
—
450161
BLUE CROSS
GA
Enumeration date
04/03/2006
Last updated
02/22/2008
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