Provider Demographics
NPI:1922006592
Name:SIDDIQUI, ANWARUL BASHAR (MD)
Entity Type:Individual
Prefix:DR
First Name:ANWARUL
Middle Name:BASHAR
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 1:807 E. PRESCOTT AVE
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-7412
Mailing Address - Country:US
Mailing Address - Phone:785-833-2220
Mailing Address - Fax:785-833-2221
Practice Address - Street 1:807 E. PRESCOTT AVE
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-7412
Practice Address - Country:US
Practice Address - Phone:785-833-2220
Practice Address - Fax:785-833-2221
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-08
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-296052084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100427040BMedicaid
KSH60782Medicare UPIN
KS100427040BMedicaid