Provider Demographics
NPI:1164443107
Name:SIDIQUE, YUSUF (MD)
Entity Type:Individual
Prefix:
First Name:YUSUF
Middle Name:
Last Name:SIDIQUE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:YUSUF
Other - Middle Name:A
Other - Last Name:ANJAMPARATHIKAL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:126 ENCLAVE DR # 106
Mailing Address - Street 2:
Mailing Address - City:SEVEN FIELDS
Mailing Address - State:PA
Mailing Address - Zip Code:16046-7900
Mailing Address - Country:US
Mailing Address - Phone:724-939-6712
Mailing Address - Fax:724-939-6712
Practice Address - Street 1:126 ENCLAVE DR # 106
Practice Address - Street 2:
Practice Address - City:SEVEN FIELDS
Practice Address - State:PA
Practice Address - Zip Code:16046-7900
Practice Address - Country:US
Practice Address - Phone:724-939-6712
Practice Address - Fax:724-939-6712
Is Sole Proprietor?:No
Enumeration Date:2006-07-23
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD065152L207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0000538591OtherHIGHMARK
PA0018183620001Medicaid
PA0000538591OtherHIGHMARK