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General NPI Number Information
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NPI Number | 1730124256
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Entity Type | Individual
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Provider Name | SEAN MICHAEL BIDIC MD
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Gender | Male
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Dates
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Enumeration Date | 06/18/2006
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Last Update Date | 09/12/2018
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Provider Practice Location Address
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Address Line | 199 MULLICA HILL RD
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City | MULLICA HILL
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State | NJ
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Zip | 08062
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Country | US
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Telephone | 856-362-8898
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Fax | 856-362-8903
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Provider Business Mailing Address
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Address Line | 199 MULLICA HILL RD
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City | MULLICA HILL
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State | NJ
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Zip | 08062-2655
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Country | US
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Telephone | 856-362-8898
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Fax | 856-362-8903
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2082S0105X
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Taxonomy Name | Surgery of the Hand (Plastic Surgery) Physician
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License Number | 25MA08686600
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 25MA08686600
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License Number State | NJ
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