Provider Demographics
NPI:1235192584
Name:BIDUS, MICHAEL ALLAN (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ALLAN
Last Name:BIDUS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8166 MISSISSIPPI RD
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20724-6123
Mailing Address - Country:US
Mailing Address - Phone:240-418-2979
Mailing Address - Fax:
Practice Address - Street 1:11511 CANTERWOOD BLVD NW STE 100
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98332
Practice Address - Country:US
Practice Address - Phone:253-382-8150
Practice Address - Fax:253-382-8155
Is Sole Proprietor?:No
Enumeration Date:2006-04-08
Last Update Date:2018-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60391889207VX0201X
PAMD060320L207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology