Organization
FIRST AMBULATORY SURGERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAZIA MERAJ SIDDIQUI MD (OWNER)
(765) 252-0828
Entity
Organization
Contact information
Practice address
107 S WASHINGTON ST STE A, KOKOMO, IN 46901-4601
(765) 252-0828
(765) 471-3721
Mailing address
107 S WASHINGTON ST STE A, KOKOMO, IN 46901-4601
(765) 252-0828
(765) 471-3721
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
11/21/2023
Last updated
11/21/2023
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