Provider Demographics
NPI:1114968856
Name:BIDAWID, HELEN SUSAN (MD)
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:SUSAN
Last Name:BIDAWID
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 634706
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-1983
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:990 OAK RIDGE TPKE
Practice Address - Street 2:
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830-6976
Practice Address - Country:US
Practice Address - Phone:865-481-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000030918207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3838216Medicaid
TN4099831OtherBLUE CROSS
TN3838217Medicaid
TN4099825OtherBLUE CROSS
TNP00235979OtherRRGA
TN3838218Medicaid
TN4136464OtherBLUE CROSS
TNP00232039OtherRAILROAD
TN3838216Medicare ID - Type Unspecified
TNP00235979OtherRRGA
TN3838216Medicaid
TN3838217Medicaid
TN3838218Medicaid