Individual
NUSRAT SIDDIQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
22 S GREENE ST, ROOM N3E09, BALTIMORE, MD 21201-1544
(410) 328-6110
Mailing address
1701 TWIN SPRINGS RD, BALTIMORE, MD 21227-3553
(410) 737-5400
(410) 737-5401
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D0079165
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/27/2012
Last updated
07/21/2016
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