Provider Demographics
NPI:1194857995
Name:STRIDER, MICHAEL W (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:W
Last Name:STRIDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:110 HOSPITAL RD
Mailing Address - Street 2:SUITE #211
Mailing Address - City:PRINCE FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:20678-4019
Mailing Address - Country:US
Mailing Address - Phone:410-257-3150
Mailing Address - Fax:410-535-3912
Practice Address - Street 1:110 HOSPITAL RD
Practice Address - Street 2:SUITE #202
Practice Address - City:PRINCE FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:20678-4019
Practice Address - Country:US
Practice Address - Phone:410-257-3150
Practice Address - Fax:410-535-3912
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0044711207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
421599-03OtherBLUE SHIELD OF MARYLAND
6906-0004OtherBLUE SHIELD DC
2217660OtherAETNA US HEALTHCARE
366484OtherMAMSI UNITED HEALTH CARE
A72099Medicare UPIN
MD059N909FMedicare ID - Type Unspecified