Provider Demographics
NPI:1972886901
Name:SIDDIQUI, ZAKI H
Entity type:Individual
Prefix:
First Name:ZAKI
Middle Name:H
Last Name:SIDDIQUI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1098 PRESCOTT DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48309-4903
Mailing Address - Country:US
Mailing Address - Phone:248-795-0883
Mailing Address - Fax:
Practice Address - Street 1:15627 W 9 MILE RD
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-3718
Practice Address - Country:US
Practice Address - Phone:248-809-6024
Practice Address - Fax:248-809-6045
Is Sole Proprietor?:No
Enumeration Date:2011-09-26
Last Update Date:2024-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302039805183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist