Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Id Micro PLLC

Organization Infectious Disease Physician · NPI 1477598076

Id Micro PLLC is an Infectious Disease Physician in Kingsport, Tennessee. Licensed in Tennessee. Registered with an NPI since 2006.

Licensed in
TN
In the registry since
2006
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

130 W Ravine Rd
Kingsport, TN 37660-3837
Phone: (423) 915-1126
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Infectious Disease Physician (primary) Taxonomy 207RI0200X · Licence MD38189 (TN)

Record details

NPI number1477598076
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Anton Maki — Owner · (423) 915-1126
NPI enumeratedJune 18, 2006
Last updated in NPPESJanuary 24, 2012
Mailing address130 W Ravine Rd, Kingsport, TN 37660-3837

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