Individual
MR. RICHARD WAYNE SIDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 OSBORN BLVD, SAULT STE MARIE, MI 49783
(906) 635-4438
(906) 635-4467
Mailing address
PO BOX 1108, ATTN BARB SIMMONS, ANN ARBOR, MI 48106-1108
(734) 677-7400
(734) 677-1603
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
4301029531
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4920637
—
MI
Enumeration date
11/01/2006
Last updated
10/03/2007
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