Individual
FARHAN SIDDIQUI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
535 COLISEUM DR, MACON, GA 31217-0104
(478) 972-0277
Mailing address
PO BOX 26698, MACON, GA 31221-6698
(478) 972-0277
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
042432
GA
207RI0200X
Infectious Disease Physician
042432
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000757831F
—
GA
Enumeration date
10/14/2005
Last updated
09/19/2019
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