Individual
TAHIR SIDDIQ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
102 CONECUH AVE W, UNION SPRINGS, AL 36089-1303
(334) 738-2140
(334) 738-1511
Mailing address
102 CONECUH AVE W, UNION SPRINGS, AL 36089-1303
(469) 530-4932
(469) 257-3501
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
19681
AL
207P00000X
Emergency Medicine Physician
19681
AL
207R00000X
Internal Medicine Physician
19681
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000034042
—
AL
01
—
051034042
BCBS
AL
01
—
110128435
RAILROAD MEDICARE
—
Enumeration date
08/25/2006
Last updated
07/13/2022
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