Individual
ANWER MUKHTAR SIDDIQI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
655 W 8TH ST, JACKSONVILLE, FL 32209-6511
(904) 244-4218
(904) 244-4060
Mailing address
PO BOX 44008, PROVIDER ENROLLMENT, JACKSONVILLE, FL 32231-4008
(904) 244-4218
(904) 244-4060
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
ME113588
FL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
17808
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00126474
—
MS
05
—
003127931A
—
GA
05
—
007244100
—
FL
01
—
14N4J
BCBS FL
FL
05
—
1885797
—
MS
01
—
P00236922
RR MEDICARE
MS
01
—
P00622805
RR MEDICARE
MS
Enumeration date
07/11/2006
Last updated
03/19/2013
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