Provider Demographics
NPI:1225175714
Name:SIDDIQI, SAROSH F (MD)
Entity Type:Individual
Prefix:
First Name:SAROSH
Middle Name:F
Last Name:SIDDIQI
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 1:9809 NE 30TH ST
Mailing Address - Street 2:G-10
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-1840
Mailing Address - Country:US
Mailing Address - Phone:253-347-2606
Mailing Address - Fax:561-282-3238
Practice Address - Street 1:1560 N 115TH ST
Practice Address - Street 2:G-10
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133-8414
Practice Address - Country:US
Practice Address - Phone:260-368-1558
Practice Address - Fax:206-368-5751
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00042673174400000X, 207R00000X, 207RC0200X, 207RP1001X
IN01079807A207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No174400000XOther Service ProvidersSpecialist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAP00272135OtherRAILROAD MEDICARE
WA8378432Medicaid
WAP00272135OtherRAILROAD MEDICARE
WA8378432Medicaid