Provider Demographics
NPI:1366521387
Name:AYESHA M. SIKDER MD LLC
Entity type:Organization
Organization Name:AYESHA M. SIKDER MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AYESHA
Authorized Official - Middle Name:M
Authorized Official - Last Name:SIKDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:606-886-8880
Mailing Address - Street 1:5230 KY ROUTE 321
Mailing Address - Street 2:SUITE # 4
Mailing Address - City:PRESTONSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41653-9168
Mailing Address - Country:US
Mailing Address - Phone:606-886-8880
Mailing Address - Fax:606-886-8628
Practice Address - Street 1:5230 KY ROUTE 321
Practice Address - Street 2:SUITE # 4
Practice Address - City:PRESTONSBURG
Practice Address - State:KY
Practice Address - Zip Code:41653-9168
Practice Address - Country:US
Practice Address - Phone:606-886-8880
Practice Address - Fax:606-886-8628
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2010-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY65941866Medicaid
KY9336Medicare ID - Type Unspecified