Organization
MOHAMMED A. SIDDIQUI, M.D., PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMMED A SIDDIQUI M.D. (OWNER)
(270) 769-2475
Entity
Organization
Contact information
Practice address
1120 WOODLAND DR, ELIZABETHTOWN, KY 42701-2763
(270) 769-2475
Mailing address
1120 WOODLAND DR, ELIZABETHTOWN, KY 42701-2763
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
07/14/2014
Last updated
07/14/2014
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