Provider Demographics
NPI:1235496340
Name:SIDHOM, MICHAEL M (MD, MSPH)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:M
Last Name:SIDHOM
Suffix:
Gender:M
Credentials:MD, MSPH
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Other - Credentials:
Mailing Address - Street 1:153 BRODHEAD RD
Mailing Address - Street 2:ST. LUKE'S NORTH - DEPT. OF OCCUPATIONAL MEDICINE
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017
Mailing Address - Country:US
Mailing Address - Phone:484-526-3005
Mailing Address - Fax:484-526-3242
Practice Address - Street 1:153 BRODHEAD RD
Practice Address - Street 2:ST. LUKE'S NORTH - DEPT. OF OCCUPATIONAL MEDICINE
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017
Practice Address - Country:US
Practice Address - Phone:484-526-3005
Practice Address - Fax:484-526-3242
Is Sole Proprietor?:No
Enumeration Date:2012-04-13
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD456181207Q00000X, 207QG0300X, 2083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine