Individual provider · Type 1 NPI

Michael Itidiare, DO, M.B.S

Gastroenterology Physician · Kingsport, TN

NPI number 1316388556 Active

Practice location

130 W Ravine Rd
Kingsport, TN 37660-3837

Call (423) 224-4000 Map

Mailing address

1 Capital Way
Pennington, NJ 08534-2520

Other practice locations

  • 1 Capital Way, Pennington, NJ 08534-2520 · (609) 303-4000
  • 1 Medical Park Blvd, Bristol, TN 37620-7430 · (423) 844-1121

Specialties and licenses

TaxonomyCodeLicense
Gastroenterology Physician Primary 207RG0100X25MB10130600 (NJ)
Internal Medicine Physician 207R00000X6450 (TN)
Internal Medicine Physician 207R00000X0102208235 (VA)
Gastroenterology Physician 207RG0100X6450 (TN)
Gastroenterology Physician 207RG0100X0102208235 (VA)

Gastroenterology Physician: An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

179 other providers at this address

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About NPI 1316388556

Michael Itidiare, DO, M.B.S's National Provider Identifier is 1316388556, issued on Jul 16, 2013. The primary taxonomy on file is Gastroenterology Physician (207RG0100X), and the practice location is in Kingsport, TN. The record was last updated on Feb 25, 2026.