Healthcare Provider Details

I. General information

NPI: 1235496340
Provider Name (Legal Business Name): MICHAEL M SIDHOM M.D., M.S.P.H.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2012
Last Update Date: 07/31/2025
Certification Date: 07/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

153 BRODHEAD RD ST. LUKE'S NORTH - DEPT. OF OCCUPATIONAL MEDICINE
BETHLEHEM PA
18017
US

IV. Provider business mailing address

153 BRODHEAD RD ST. LUKE'S NORTH - DEPT. OF OCCUPATIONAL MEDICINE
BETHLEHEM PA
18017
US

V. Phone/Fax

Practice location:
  • Phone: 484-526-3005
  • Fax: 484-526-3242
Mailing address:
  • Phone: 484-526-3005
  • Fax: 484-526-3242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD456181
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License NumberMD456181
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License NumberMD456181
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: