Provider Demographics
NPI:1528023603
Name:SIDDIQI, USMAN M (MD)
Entity Type:Individual
Prefix:MR
First Name:USMAN
Middle Name:M
Last Name:SIDDIQI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:100 EAST COMMERCIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33334
Mailing Address - Country:US
Mailing Address - Phone:954-351-0202
Mailing Address - Fax:954-351-0201
Practice Address - Street 1:100 EAST COMMERCIAL BLVD
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33334
Practice Address - Country:US
Practice Address - Phone:954-351-0202
Practice Address - Fax:954-351-0201
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME0060159208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
F24237Medicare UPIN