Provider Demographics
NPI:1326023367
Name:SARAYDARIAN, MICHAEL CARL (DPM)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:CARL
Last Name:SARAYDARIAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 MEDICAL CENTER DR
Mailing Address - Street 2:SUITE 2100
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-2690
Mailing Address - Country:US
Mailing Address - Phone:207-725-4008
Mailing Address - Fax:207-725-5749
Practice Address - Street 1:81 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 2100
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011-2690
Practice Address - Country:US
Practice Address - Phone:207-725-4008
Practice Address - Fax:207-725-5749
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPOD 1027213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME434673000Medicaid
ME416380099Medicaid
MELX5112Medicare UPIN
MEMM7709Medicare ID - Type Unspecified
ME416380099Medicaid
ME434673000Medicaid
MEMM0716Medicare UPIN