Individual
DR. REAZ SIDDIQUI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3921 SHALLOWFORD RD, MARIETTA, GA 30062-5013
(770) 649-0049
(770) 649-9092
Mailing address
1816 PEMBERTON PL, MARIETTA, GA 30062-8126
(770) 518-4199
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
63733
GA
207R00000X
Internal Medicine Physician
D0063087
MD
Other
Enumeration date
04/05/2006
Last updated
02/27/2020
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