Individual
MOHAMED S SIDDIQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
27207 LAHSER RD, STE 200B, SOUTHFIELD, MI 48034-8407
(248) 354-4709
(248) 354-4807
Mailing address
17177 N LAUREL PARK DR, STE 439, LIVONIA, MI 48152-3938
(248) 354-4709
(248) 354-4807
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MS044111
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104722864
—
MI
Enumeration date
05/13/2006
Last updated
02/22/2016
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