Provider Demographics
NPI:1902902729
Name:BIDDINGER, ALAN L (MD PHD)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:L
Last Name:BIDDINGER
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6905 ROCHESTER RD
Mailing Address - Street 2:B
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48085-1282
Mailing Address - Country:US
Mailing Address - Phone:248-828-1100
Mailing Address - Fax:248-828-1101
Practice Address - Street 1:6905 ROCHESTER RD
Practice Address - Street 2:B
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48085-1282
Practice Address - Country:US
Practice Address - Phone:248-828-1100
Practice Address - Fax:248-828-1101
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2011-09-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301070667207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0F39103OtherBCBS
MI4442163Medicaid
MI4442163Medicaid
MI0P21020Medicare PIN