Individual
SHAZ SIDDIQI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
44160 SCHOLAR PLZ, SUITE 390, LANSDOWNE, VA 20176-3459
(703) 938-3900
(703) 726-2579
Mailing address
44160 SCHOLAR PLZ, SUITE 390, LANSDOWNE, VA 20176-3459
(703) 938-3900
(703) 726-2579
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
0101250699
VA
207K00000X
Allergy & Immunology Physician
D0062974
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020282ZRGM
MEDICARE PTAN
DC
Enumeration date
06/17/2006
Last updated
11/17/2015
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