Individual
DR. MARTIN BYDALEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2819 DENNY AVE, PASCAGOULA, MS 39581
(228) 762-3466
Mailing address
2819 DENNY AVENUE, PASCAGOULA, MS 39581
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
MS10633
MS
207Q00000X
Family Medicine Physician
Primary
10633
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00015597
—
MS
05
—
008605220
—
AL
01
—
386693YKC0
MEDICARE
MS
01
—
646000515
TRICARE
—
01
—
930026514
RAILROAD MEDICARE
—
Enumeration date
01/12/2007
Last updated
02/11/2016
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