Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. MICHAEL ITIDIARE, D.O., M.B.S
Active Sole ProprietorDR. MICHAEL ITIDIARE, D.O., M.B.S is a Gastroenterology healthcare provider located in KINGSPORT, Tennessee. NPI 1316388556 is currently active in the NPPES registry. Verify at CMS.
Gastroenterology · KINGSPORT, TN
Registration Details
- NPI Number
- 1316388556
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 16, 2013 (13.10890288903 yrs)
- Last Updated
- Feb 25, 2026
- Licenses
-
25MB10130600 (NJ)6450 (TN)0102208235 (VA)6450 (TN)0102208235 (VA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
130 W RAVINE RDKINGSPORT, TN, 376603837Browse TN providers · Browse ZIP 37660
- Phone
- 4232244000
- Primary Specialty
-
Gastroenterology
207RG0100X
- Additional Specialty
- Internal Medicine
- Additional Specialty
- Internal Medicine
- Additional Specialty
- Gastroenterology
- Additional Specialty
- Gastroenterology
Other Gastroenterology Providers in KINGSPORT, TN
| Name | Credential | NPI |
|---|---|---|
| DR. DALLAS SHONE | MD | 1043213101 |
| JEFFREY P FENYVES | M.D. | 1700887106 |
| STEPHEN W FRY | M.D. | 1750382982 |
| DR. DOUGLAS J SPRINGER | M.D | 1336134816 |
| DR. FREDRIC R MISHKIN | M.D | 1134114614 |
| DR. DOUGLAS E HOMOKY | M.D. | 1073508560 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.