Provider Demographics
NPI:1497015507
Name:AQEEL M SIDDIQUI MD LTD
Entity Type:Organization
Organization Name:AQEEL M SIDDIQUI MD LTD
Other - Org Name:VASCULAR CARE SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AQEEL
Authorized Official - Middle Name:MOHAMMAD
Authorized Official - Last Name:SIDDIQUI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-240-0906
Mailing Address - Street 1:830 OAK ST STE 200W
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301-1191
Mailing Address - Country:US
Mailing Address - Phone:774-480-1600
Mailing Address - Fax:
Practice Address - Street 1:830 OAK ST STE 200W
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-1191
Practice Address - Country:US
Practice Address - Phone:774-480-1600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-22
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1522102086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty