Provider Demographics
NPI:1558527580
Name:SIDDIQUI, NAJMUL HASAN (MD)
Entity Type:Individual
Prefix:
First Name:NAJMUL
Middle Name:HASAN
Last Name:SIDDIQUI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 S PEORIA ST
Mailing Address - Street 2:#100
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-5476
Mailing Address - Country:US
Mailing Address - Phone:720-524-1550
Mailing Address - Fax:720-524-1551
Practice Address - Street 1:2400 S PEORIA ST
Practice Address - Street 2:#100
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-5476
Practice Address - Country:US
Practice Address - Phone:720-524-1550
Practice Address - Fax:720-524-1551
Is Sole Proprietor?:No
Enumeration Date:2008-07-30
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE5786207Q00000X
CO50278207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO40135063Medicaid
CO40135063Medicaid