Provider Demographics
NPI:1740492909
Name:SIDDIQUI, NADEEM S (MD MPH)
Entity type:Individual
Prefix:DR
First Name:NADEEM
Middle Name:S
Last Name:SIDDIQUI
Suffix:
Gender:M
Credentials:MD MPH
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:8186 LARK BROWN RD
Mailing Address - Street 2:STE 201
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-6434
Mailing Address - Country:US
Mailing Address - Phone:410-730-3399
Mailing Address - Fax:410-740-4776
Practice Address - Street 1:1460 N CENTER RD
Practice Address - Street 2:
Practice Address - City:BURTON
Practice Address - State:MI
Practice Address - Zip Code:48509-1429
Practice Address - Country:US
Practice Address - Phone:810-715-4620
Practice Address - Fax:810-715-4602
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2016-11-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI43010722342083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4375427Medicaid
MI0N46160Medicare ID - Type Unspecified
MI4375427Medicaid