Provider Demographics
NPI:1760525471
Name:SIDDIQUI, MEHAR M (MD)
Entity Type:Individual
Prefix:DR
First Name:MEHAR
Middle Name:M
Last Name:SIDDIQUI
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 1:2544 PARTRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33884-3035
Mailing Address - Country:US
Mailing Address - Phone:863-318-9193
Mailing Address - Fax:863-324-0933
Practice Address - Street 1:2544 PARTRIDGE DR
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33884-3035
Practice Address - Country:US
Practice Address - Phone:863-318-9193
Practice Address - Fax:863-324-0933
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME31293208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics