Organization
KIDS CLINIC PEDIATRIC AND ADOLESCENT MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MUHAMMED KHURRAM SIDDIQUI MD (OWNER)
(256) 268-7775
Entity
Organization
Contact information
Practice address
119 STEPHEN J WHITE MEMORIAL BLVD, TALLADEGA, AL 35160-2106
(256) 268-7775
Mailing address
119 STEPHEN J WHITE MEMORIAL BLVD, TALLADEGA, AL 35160-2106
(256) 268-7775
(256) 268-7760
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000032739
—
AL
01
—
G50661
UPIN
—
Enumeration date
05/04/2018
Last updated
09/26/2023
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