Provider Demographics
NPI:1073780037
Name:SIDDIQUI, SAMEENA KHAN (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMEENA
Middle Name:KHAN
Last Name:SIDDIQUI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10-1-13/3 A.C . GUARDS, HYDERABAD,
Mailing Address - Street 2:
Mailing Address - City:HYDERABAD
Mailing Address - State:A.P.
Mailing Address - Zip Code:500004
Mailing Address - Country:IN
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2540 N MORELAND BLVD
Practice Address - Street 2:
Practice Address - City:SHAKER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44120-1375
Practice Address - Country:US
Practice Address - Phone:312-733-5448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-09
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57.0133652084N0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology