Individual
MICHAEL M. LIDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8075 N SHADELAND AVE STE 330, INDIANAPOLIS, IN 46250-2694
(317) 355-7220
Mailing address
1261 S TAMIAMI TRL, SARASOTA, FL 34239-2219
(941) 366-1164
(941) 366-3123
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01091926A
IN
207L00000X
Anesthesiology Physician
2024042416
MO
207L00000X
Anesthesiology Physician
79070
AZ
207L00000X
Anesthesiology Physician
ME110099
FL
207L00000X
Anesthesiology Physician
W1624
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004003300
—
FL
01
—
14F6M
BLUE CROSS BLUE SHIELD
FL
Enumeration date
05/25/2007
Last updated
01/19/2026
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