Provider Demographics
NPI:1508918095
Name:BIDIUC, MARTHA E (MD)
Entity Type:Individual
Prefix:DR
First Name:MARTHA
Middle Name:E
Last Name:BIDIUC
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1421 ROSS DR
Mailing Address - Street 2:STE 4
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30720-3095
Mailing Address - Country:US
Mailing Address - Phone:706-876-1911
Mailing Address - Fax:706-876-1937
Practice Address - Street 1:1421 ROSS DR
Practice Address - Street 2:STE 4
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30720-3095
Practice Address - Country:US
Practice Address - Phone:706-876-1911
Practice Address - Fax:706-876-1937
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA0516232084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAH63860Medicare UPIN