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Individual

TASNEEM SIDDIQUA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
6002 E 38TH ST, INDIANAPOLIS, IN 46226-5614
(317) 880-6002
(317) 880-0417
Mailing address
PO BOX 637764, CINCINNATI, OH 45263-7764
(317) 880-3939
(317) 880-0343

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01079021A
IN
207R00000X
Internal Medicine Physician
125058089
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
300005364
IN
Enumeration date
07/21/2010
Last updated
04/08/2026
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