Provider Demographics
NPI:1528273463
Name:M RASHID SIDDIQUI, MD, PC
Entity type:Organization
Organization Name:M RASHID SIDDIQUI, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:M
Authorized Official - Middle Name:RASHID
Authorized Official - Last Name:SIDDIQUI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:517-629-8416
Mailing Address - Street 1:505 KEEFER DR
Mailing Address - Street 2:
Mailing Address - City:ALBION
Mailing Address - State:MI
Mailing Address - Zip Code:49224-1555
Mailing Address - Country:US
Mailing Address - Phone:517-629-8416
Mailing Address - Fax:517-629-6640
Practice Address - Street 1:505 KEEFER DR
Practice Address - Street 2:
Practice Address - City:ALBION
Practice Address - State:MI
Practice Address - Zip Code:49224-1555
Practice Address - Country:US
Practice Address - Phone:517-629-8416
Practice Address - Fax:517-629-6640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2007-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1073709-10Medicaid
MI01304452Medicare PIN
MID90122Medicare UPIN