Provider Demographics
NPI:1700536828
Name:SIDDIQ, NAJEEB KHALID (MD)
Entity Type:Individual
Prefix:DR
First Name:NAJEEB
Middle Name:KHALID
Last Name:SIDDIQ
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 1:1000 CORPORATE CENTER DR STE 200
Mailing Address - Street 2:
Mailing Address - City:MORROW
Mailing Address - State:GA
Mailing Address - Zip Code:30260-4129
Mailing Address - Country:US
Mailing Address - Phone:770-968-6460
Mailing Address - Fax:
Practice Address - Street 1:1000 CORPORATE CENTER DR STE 200
Practice Address - Street 2:
Practice Address - City:MORROW
Practice Address - State:GA
Practice Address - Zip Code:30260-4129
Practice Address - Country:US
Practice Address - Phone:770-968-6460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-24
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program