Individual
DR. MICHAEL L LYDIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10777 NALL AVE, SUITE 200, OVERLAND PARK, KS 66211-1362
(913) 588-2229
(913) 588-6258
Mailing address
3901 RAINBOW BLVD, KANSAS CITY, KS 66160-8500
Taxonomy
Speciality
Code
Description
License number
State
207VE0102X
Reproductive Endocrinology Physician
Primary
04-38611
KS
207VE0102X
Reproductive Endocrinology Physician
2015041854
MO
207VE0102X
Reproductive Endocrinology Physician
209845
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01816444
—
NY
01
—
4640733
AETNA
NY
01
—
48G612
EMPIRE BC.BS
NY
Enumeration date
06/27/2006
Last updated
03/30/2016
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