Basic Information
| Provider Information | |||||||||
| NPI: | 1912942723 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BISHOP | ||||||||
| FirstName: | DUANE | ||||||||
| MiddleName: | S. | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 18 HERITAGE RD | ||||||||
| Address2: | |||||||||
| City: | BARRINGTON | ||||||||
| State: | RI | ||||||||
| PostalCode: | 028062711 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4012470971 | ||||||||
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| Practice Location | |||||||||
| Address1: | 100 PAGE ST | ||||||||
| Address2: | SNEPA | ||||||||
| City: | NEW BEDFORD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 027403465 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5089615930 | ||||||||
| FaxNumber: | 5089615931 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/17/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | 70425 | MA | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | 2084P0800X | MD05591 | RI | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
ID Information
| ID | Type | State | Issuer | Description | 3084680 | 05 | MA | MEDICAID |