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JOHN EDWARD MIDTLING

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
8299 161ST AVE NE, #101, REDMOND, WA 98052-3860
(425) 881-8813
(425) 869-7201
Mailing address
PO BOX 34036, SEATTLE, WA 98124-1036
(425) 899-3292
(425) 899-3269

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
37234
TN
207Q00000X
Family Medicine Physician
Primary
MD60139996
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
190944
UNISON
TN
01
2504635
CIGNA
TN
01
38128
TLC
TN
05
3818686
TN
01
4135399
BLUE CROSS BLUE SHIELD
TN
01
626001636
UNITED HEALTHCARE
TN
Enumeration date
06/21/2006
Last updated
02/16/2011
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