Individual
MICHAEL A SARIDAKIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
310 N L ROGERS WELLS BLVD STE 103, GLASGOW, KY 42141-1300
(270) 659-5945
(270) 659-5855
Mailing address
310 N L ROGERS WELLS BLVD, GLASGOW, KY 42141-1300
(270) 659-5945
(270) 659-5855
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
29430
TN
208600000X
Surgery Physician
Primary
48331
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3814598
—
TN
05
—
7100356140
—
KY
01
—
K130430
MEDICARE
KY
Enumeration date
06/10/2005
Last updated
04/24/2023
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