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Individual

DR. TALHA SIDDIQUI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
6164 FULLER CT, ALEXANDRIA, VA 22310-2540
(571) 257-9580
Mailing address
6164 FULLER CT, ALEXANDRIA, VA 22310-2540
(571) 257-9580

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
0101233817
VA
208VP0014X
Interventional Pain Medicine Physician
Primary
0101233817
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1013928142
VA
05
1548443153
VA
Enumeration date
08/11/2006
Last updated
05/05/2017
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