Provider Demographics
NPI:1548231723
Name:RIDNER, MICHAEL LLOYD (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:LLOYD
Last Name:RIDNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 FRANKLIN ST SE
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4312
Mailing Address - Country:US
Mailing Address - Phone:256-539-4080
Mailing Address - Fax:256-539-4099
Practice Address - Street 1:930 FRANKLIN ST SE
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4312
Practice Address - Country:US
Practice Address - Phone:256-539-4080
Practice Address - Fax:256-539-4099
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2009-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL14612207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
4072215OtherAETNA
AL510-33799OtherBCBS
AL111661Medicaid
AL111667Medicaid
AL510-49275OtherBCBS
060037259OtherRAILROAD MEDICARE
AL111659Medicaid
AL111663Medicaid
AL510-49374OtherBCBS
AL510-49375OtherBCBS
AL000033799Medicaid
AL510-49273OtherBCBS
AL515-98520OtherBCBS
AL111660Medicaid
AL111665Medicaid
TN0098921OtherBCBS
25-10159OtherUNITED HEALTHCARE
AL510-49274OtherBCBS
ALP00744573OtherRAILROAD MEDICARE
AL111660Medicaid
TN0098921OtherBCBS
AL111665Medicaid
AL102I063652Medicare PIN