Provider Demographics
NPI:1750359857
Name:FRIDAY, MICHELE A (MD)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:A
Last Name:FRIDAY
Suffix:
Gender:
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:PO BOX 2379
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41105-2379
Mailing Address - Country:US
Mailing Address - Phone:606-833-0144
Mailing Address - Fax:606-833-0113
Practice Address - Street 1:1180 SAINT CHRISTOPHER DR STE 2
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-7055
Practice Address - Country:US
Practice Address - Phone:606-833-0144
Practice Address - Fax:606-833-0113
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY37738207RC0000X
OH35.140639207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2757940Medicaid
KY000000609826OtherANTHEM BCBS
KY000000598310OtherANTHEM BCBS
KYP00678288OtherRR MEDICARE
KY000000522183OtherANTHEM BCBS
KY64058522Medicaid
KY000000598137OtherANTHEM BCBS
KY000000598137OtherANTHEM BCBS
KY00422001Medicare PIN
KYP00678288OtherRR MEDICARE
KY000000609826OtherANTHEM BCBS
KY00879005Medicare PIN