Provider Demographics
NPI:1740390012
Name:SADIQ, SYED AKBAR ALI (MD FACP)
Entity type:Individual
Prefix:
First Name:SYED
Middle Name:AKBAR ALI
Last Name:SADIQ
Suffix:
Gender:M
Credentials:MD FACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14333 LAUREL BOWIE ROAD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20708-1179
Mailing Address - Country:US
Mailing Address - Phone:301-776-0061
Mailing Address - Fax:301-604-9454
Practice Address - Street 1:14333 LAUREL BOWIE ROAD
Practice Address - Street 2:SUITE 208
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20708-1179
Practice Address - Country:US
Practice Address - Phone:301-776-0061
Practice Address - Fax:301-604-9454
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0024721207R00000X
DCMD12398207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD136401400Medicaid
MD136401400Medicaid
MDD09391Medicare PIN