Provider Demographics
NPI:1861676678
Name:SIDDIQI, FAISAL KHURSHEED (MD)
Entity Type:Individual
Prefix:DR
First Name:FAISAL
Middle Name:KHURSHEED
Last Name:SIDDIQI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1 BRACE RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-2600
Mailing Address - Country:US
Mailing Address - Phone:856-428-4100
Mailing Address - Fax:856-428-5748
Practice Address - Street 1:1 BRACE RD
Practice Address - Street 2:SUITE C
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-2600
Practice Address - Country:US
Practice Address - Phone:856-428-4100
Practice Address - Fax:856-428-5748
Is Sole Proprietor?:No
Enumeration Date:2007-12-28
Last Update Date:2017-02-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA09305300207RC0000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0359483Medicaid