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Individual

DR. ATHAR SIDDIQUI

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
428 S GROVE ST, YPSILANTI, MI 48198-5662
(734) 483-7136
(734) 483-3422
Mailing address
428 S GROVE ST, YPSILANTI, MI 48198-5662
(734) 483-7136
(734) 483-3422

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301034780
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
008913
MIDWEST
MI
01
0643416
UMWA
MI
05
1001085325
MI
01
103452
CARECHOICES
MI
01
1108172912
BCBS OF MI
MI
01
C1687
MCARE
MI
01
M008530
CHAMP
MI
Enumeration date
12/29/2005
Last updated
07/08/2007
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