Organization
MICHAEL K. CRIDER, M.D., PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL K CRIDER M.D. (PRESIDENT)
(765) 281-1400
Entity
Organization
Contact information
Practice address
3310 W PURDUE AVE, MUNCIE, IN 47304-6355
(765) 281-1400
(765) 282-2133
Mailing address
3310 W PURDUE AVE, MUNCIE, IN 47304-6355
(765) 281-1400
(765) 282-2133
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
01029431
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000091505
BLUE CROSS/BLUE SHIELD
IN
Enumeration date
09/19/2007
Last updated
09/19/2007
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