| Doctor Name: | DR. MICHAEL PAUL WIDICK |
| NPI Number: | 1164420071 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | ME0061454 |
| Business Practice Address: | 333 W Cocoa Beach Cswy Suite B Cocoa Beach, FL - 329313513 |
| Business Phone Number: | 3217999797 |
| Business Fax Number: | 3217993393 |
| Mailing Address: | 333 W Cocoa Beach Cswy, Suite B COCOA BEACH |
| State: | FL |
| Postal Code: | 329313513 |
| Phone Number: | 3217999797 |
| Fax Number: | 3217993393 |
| NPI Enumeration Date: | 07/13/2005 |
| NPI Last Update Date: | 02/27/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207YX0602X |
| License Number: | ME0061454 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | FL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Otolaryngology |
| Taxonomy Specialization: | Otolaryngic Allergy |
| Taxonomy Definition: | An otolaryngologist who specializes in the diagnosis and treatment of otolaryngic allergies and other allergic diseases. |