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Organization
KIDS CLINIC PEDIATRIC AND ADOLESCENT MEDICINE
Active
Organization
KIDS CLINIC PEDIATRIC AND ADOLESCENT MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MUHAMMED KHURRAM SIDDIQUI MD (OWNER)
(256) 268-7775
Entity
Organization
Contact information
Practice address
119 STEPHEN J WHITE MEMORIAL BLVD, TALLADEGA, AL 35160-2106
(256) 268-7775
Mailing address
119 STEPHEN J WHITE MEMORIAL BLVD, TALLADEGA, AL 35160-2106
(256) 268-7775
(256) 268-7760
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000032739
—
AL
01
—
G50661
UPIN
—
Enumeration date
05/04/2018
Last updated
09/26/2023
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