Provider Demographics
NPI:1053470880
Name:SIBLE, MICHAEL D (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:D
Last Name:SIBLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1213 24TH ST
Mailing Address - Street 2:SUITE 700
Mailing Address - City:ANACORTES
Mailing Address - State:WA
Mailing Address - Zip Code:98221-2592
Mailing Address - Country:US
Mailing Address - Phone:360-293-5142
Mailing Address - Fax:390-299-2043
Practice Address - Street 1:1213 24TH ST
Practice Address - Street 2:SUITE 700
Practice Address - City:ANACORTES
Practice Address - State:WA
Practice Address - Zip Code:98221-2592
Practice Address - Country:US
Practice Address - Phone:360-293-5142
Practice Address - Fax:390-299-2043
Is Sole Proprietor?:No
Enumeration Date:2006-12-07
Last Update Date:2008-05-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00026416208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8603292Medicaid
WAE20532Medicare UPIN
WA001145704Medicare PIN