Organization
LAFAYETTE PAIN CARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAZIA MERAJ SIDDIQUI MD (OWNER)
(765) 714-4344
Entity
Organization
Contact information
Practice address
1714 DIVIDEND DR, LOGANSPORT, IN 46947-1572
(765) 714-4344
Mailing address
PO BOX 5748, LAFAYETTE, IN 47903-5748
(765) 714-4344
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
Other
Enumeration date
12/01/2022
Last updated
12/01/2022
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