Organization
MIDWEST CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMMED ABDUL RAOOF SIDDIQUI MD (PRESIDENT)
(219) 865-0918
Entity
Organization
Contact information
Practice address
13 W US HWY 30, MIDWEST CLINIC, SCHERERVILLE, IN 46375
(219) 865-0918
(219) 864-8332
Mailing address
13 W US HWY 30, SCHERERVILLE, IN 46375
(219) 865-0918
(219) 864-8332
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01041447
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100356480D
—
IN
Enumeration date
10/05/2006
Last updated
10/14/2015
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