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Individual

MICHAEL DAVID CRIDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
900 HOSPITAL DR, MADISONVILLE, KY 42431-1653
(270) 825-5100
Mailing address
200 CLINIC DR, MADISONVILLE, KY 42431-1661

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
44980
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000540250
BCBS
KY
01
1096338
MEDICAL LICENSE
KY
01
5340A
MEDICAL LICENSE
KY
05
7100015430
KY
Enumeration date
10/12/2007
Last updated
01/08/2015
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