Healthcare Provider Details

I. General information

NPI: 1750359857
Provider Name (Legal Business Name): MICHELE A FRIDAY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1061 KENWOOD DR
RUSSELL KY
41169-1527
US

IV. Provider business mailing address

PO BOX 2379
ASHLAND KY
41105-2379
US

V. Phone/Fax

Practice location:
  • Phone: 606-833-0144
  • Fax:
Mailing address:
  • Phone: 606-833-0144
  • Fax: 606-833-0113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number35.140639
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number37738
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: