Provider Demographics
NPI:1376620773
Name:SIKDER, AYESHA M (MD)
Entity Type:Individual
Prefix:
First Name:AYESHA
Middle Name:M
Last Name:SIKDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:5230 KY ROUTE 321
Mailing Address - Street 2:SUITE # 4
Mailing Address - City:PRESTONSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41653-9168
Mailing Address - Country:US
Mailing Address - Phone:606-886-8880
Mailing Address - Fax:606-886-8628
Practice Address - Street 1:5230 KY ROUTE 321
Practice Address - Street 2:SUITE # 4
Practice Address - City:PRESTONSBURG
Practice Address - State:KY
Practice Address - Zip Code:41653-9168
Practice Address - Country:US
Practice Address - Phone:606-886-8880
Practice Address - Fax:606-886-8628
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY30817207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY010937200OtherBLACK LUNG
KY110140852OtherRAILROAD MEDICARE ID
KY000000002031OtherCHA PROVIDER ID
KY64308174Medicaid
KY000000039568OtherBLUE CROSS BLUE SHIELD
KY1495498OtherUMWA PROVIDER ID
KY110140852OtherRAILROAD MEDICARE ID
KYF87661Medicare UPIN