Individual
SHABANA SIDDIQUI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14000 FAIRVIEW DR, PARK NICOLLET CLINIC - BURNSVILLE, BURNSVILLE, MN 55337-5713
(952) 993-8700
(952) 993-8715
Mailing address
8170 33RD AVE S # MS 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
47275
MN
Other
Enumeration date
12/27/2005
Last updated
07/02/2021
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