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Individual

DR. ESRA SIDDEEK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
1821 S WEBSTER AVE, GREEN BAY, WI 54301-2253
(920) 496-4700
Mailing address
PO BOX 19070, GREEN BAY, WI 54307-9070
(920) 496-4700

Taxonomy

Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
2021021665
MO
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
81874-21
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100326593
WI
Enumeration date
07/01/2021
Last updated
08/01/2025
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