Theral Michael Bishop, MD Valid NPI

Individual provider · Emergency Medical Services (Emergency Medicine) Physician · Logan, UT

NPI

1376584300

Type

Individual (Type 1)

Primary specialty

Emergency Medical Services (Emergency Medicine) Physician (Emergency Medicine)

Specialty group

Allopathic & Osteopathic Physicians

Taxonomy code

207PE0004X

License number

1493181205 (UT)

Sex

Male

Sole proprietor

No

Enumerated

2006-06-09

Last updated

2007-07-08