Individual
DR. NASIRUDDIN A SIDDIQUI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8011 NEW LAGRANGE RD, SUITE 1, LOUISVILLE, KY 40222-4781
(502) 394-0402
(502) 394-0480
Mailing address
8011 NEW LAGRANGE RD, SUITE 1, LOUISVILLE, KY 40222-4781
(502) 394-0402
(502) 394-0480
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
24221
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64242217
—
KY
Enumeration date
02/23/2007
Last updated
07/08/2007
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